Substituting nonsomatic for somatic symptoms in the diagnosis of depression.

The authors examined the sensitivity and specificity of a modified version of the Research Diagnostic Criteria (RDC) for major, minor, and intermittent depressive disorder in 150 elderly male medical inpatients. Four somatic RDC symptoms were replaced with four nonsomatic symptoms. The sensitivity of the modified criteria was 87%, the specificity was 97%, and 96% of patients were correctly classified. Misclassifications were of mildly depressed patients. These results provide empirical support for the use of alternative, nonsomatic depressive symptoms when somatic symptoms are ambiguous indicators of depression.