The Relation Between Anger Expression, Depression, and Somatic Symptoms in Depressive Disorders and Somatoform Disorders
J Clin Psychiatry 2005;66(4):485-491
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: In previous studies, the
relationship between either anger suppression and depression or
anger suppression and somatic symptoms was examined. However, the
relationship between anger expression, depression, and somatic
symptoms was not examined in depressive disorders and somatoform
Method: The DSM-IV-diagnosed subjects included
73 patients with depressive disorders and 47 patients with
somatoform disorders. The Anger Expression Scale was used to
assess the level of anger expression or suppression. The severity
of depression was assessed using the Symptom Checklist-90-Revised
(SCL-90-R). The Somatization Rating Scale and the SCL-90-R
somatization subscale were used to assess the severity of somatic
symptoms. Data were collected from March 2000 to March 2001.
Results: The results of the path analyses showed
that in depressive disorder patients, anger expression had a
stronger effect on somatic symptoms through depression than did
anger suppression, although both anger expression and anger
suppression had a significant indirect effect on somatic
symptoms. The depressive disorder group also showed a significant
but negative direct effect of anger suppression on anger
expression in the path from anger suppression to anger expression
to depression to somatic symptoms. However, only anger
suppression had an indirect effect on somatic symptoms through
depression in somatoform disorder patients.
Conclusions: The results suggest that anger
expression might play a more predominant role in depression and
somatic symptoms of depressive disorder patients than anger
suppression, but only anger suppression might be associated with
depression and somatic symptoms of somatoform disorder patients.
In addition, incomplete anger suppression followed by anger
expression is likely to be associated with depression and somatic
symptoms in depressive disorders.