Cultural and developmental factors affecting the presentation of somatic symptoms in depression: The case of turkish patients

Major Depressive Disorder is a frequent cause of morbidity worldwide. Depression and pain disorders/symptoms are common co-morbidities. The current definitions of depression mention pain but they describe it as a secondary or uncommon symptom. This emphasis on affective symptoms may contribute to under-recognition of pain and other physical symptoms in patients with depression. The differing patterns of symptoms of depression, both over life time and within different cultures may reflect various mechanisms, cultural and economical. Therefore, we aimed to focus on painful/somatic symptoms of depression in studies reported from Turkey both in native and in migrant populations and compare the results with studies reported from other Asian and European countries. As a result, we have found that somatic symptoms are a prominent feature of Asian populations with depression, including Turkey, but that the latter also tend to report cognitive symptoms similar to Western populations with depression. The relationship of pain and somatic symptoms with depression may be complex. Further studies are needed to explain the co-morbidity of pain and depression.