[Skip to Content]
[Skip to Content Landing]
June 1990

Depressed or Just Sick?

Arch Intern Med. 1990;150(6):1349. doi:10.1001/archinte.1990.00390180147034

To the Editor.—Depressive symptomatology is common in elderly patients admitted to a Veterans Administration acute medical ward, as reported in the September 1989 issue of the Archives.1 The authors also found that symptoms thought due to physical illness had a profound impact on the results of the Hamilton Depression Scale. This was demonstrated by the calculation of an adjusted score "to account systematically for at least a portion of the influence of physical illness on symptoms attributed to psychiatric processes." No similar attempt was made to assess the influence of physical illness on the DSM-III criteria used to diagnose a major depression. I find that many patients admitted for physical illness(es) complain of one or more of the following criteria: loss of energy, decreased appetite or weight loss, insomnia, decreased concentration, depressed mood. I question whether this might result in overdiagnosis of major depression. The authors reported that