Somatic symptoms- overlooked in diagnosis?

Described as ‘Perception of physical symptoms from an emotional cause’ they can be present as sleep problems, generalised and specific pain, appetite loss, energy loss dizziness, palpitations etc. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1192435/ )

 And they can be attributed to many other causes besides mental health difficulties.

 However how often are they present and misattributed?

 In a study by the WHO reported that half the depressed patients reported multiple unexplained somatic symptoms and 11 percent denied psychological symptoms of depression on direct questioning (http://www.ncbi.nlm.nih.gov/pubmed/10536124 )

 And according to( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1192435/) in approximately two thirds of patients with depression, the clinical picture is dominated by somatic symptoms, such as lack of energy and general aches and pains, which patients frequently attribute to normalizing causes. As a result, many physicians become preoccupied with lengthy investigations into possible underlying organic disease rather than considering depression as a diagnosis. Indeed, depression is mostly difficult to recognize in patients who present with chiefly somatic complaints.

So why then, if they are so common isn’t more emphasis put upon investigating possible emotional causes of symptoms? or is it simply that the patients themselves are unwilling to investigate those causes?

It has been my experience that often those who suffer are not in touch with how they feel and when asked often just shrug and say everything’s fine without really feeling that it is. Their inability to put a finger on an obvious problem has led them to say that there is no problem even when there is.

I particularly feel, however unfairly, that the buck stops with GP’s who are frequently a persons’ first port of call when they acknowledge their problems. I feel that GP’s should initiate investigation into possible emotional problems faster and more in-depth on a routine basis.

It seems an irony that when crying out to find a solution it is your ability to communicate your feelings that will gain you access to services when it is often your inability to do so that has landed you in the position of needing the help.