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Many patients who consult a primary-care care physician suffer from anxiety and/or depression to some degree, and these emotional disturbances generally play an important role in the patient's physical complaints. Based on the relationship of emotions to somatic condition, patients can be categorized into three groups. In one group of patients, anxiety/depression contributes entirely to the presenting complaints (1). When anxiety is prominent, the patient may complain of such symptoms as palpitations, breathlessness, vocal tremors, tremors of the extremities, gastrointestinal hyperactivity, excessive sweating, diarrhea, muscular tension, urinary frequency. The depressed patient may present with symptoms of excessive fatigue, lack of energy, loss of appetite, loss of libido, insomnia, chronic headache or backache, constipation, or other vegetative signs. Symptoms of anxiety and depression may also occur simultaneously. ""Masked depression" is very common; hypochondriacal complaints, psychosomatic disorders, and acting-out behavior frequently are depressive equivalents and may be precursors of true depressive reactions (2, 3). Supportive psychotherapy, with or without the use of psychotropic drugs, usually alleviates the anxiety and/or depression, along with their physical concomitants.

DOI: 10.1007/978-94-011-7289-9_18

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