Esclareciendo la Homeopatía / Clarifying Homeopathy

Mucha gente tiene un concepto equivocado de la Homeopatía, debido a que no profundiza en algunos de sus elementos básicos. Hay que empezar por entender el principio de los semejantes: "toda sustancia capaz de provocar determinados síntomas en una persona sana puede curar estos mismos síntomas en una persona enferma", para luego analizar un poco más en los síntomas físicos, mentales y generales del paciente. La Homeopatía apuesta por la individualización y por una verdadera cura, que significa alcanzar un óptimo estado de equilibrio general del paciente y no solamente la desaparición de los síntomas. (AU)

Many people have a wrong concept of homeopathy, because it does not delve into some of its basic elements. We must begin by understanding the principle of similar: "any substance capable of causing certain symptoms in a healthy person can cure these same symptoms in a sick person," and then analyze a little more in the physical, mental and general symptoms of the patient . Homeopathy is committed to individualization and a true cure, which means achieving an optimal state of general balance of the patient and not just the disappearance of symptoms. (AU)

Problemas de salud asociados al uso del teléfono celular / Health problems associated with cell phone use

Introducción: Actualmente la función de la telefonía celular conecta al usuario con el mundo a través del internet dándole acceso a un cúmulo de información. A pesar de todos los beneficios, existen problemas en salud a consecuencia del uso prolongado, se manifiestan en ansiedad, irritabilidad, inquietud y malestar general; alteraciones de la sensibilidad, lesiones cervicales, problemas visuales y cefalea. Objetivos: Analizar la existencia de problemas de salud asociados al uso del teléfono celular en estudiantes de enfermería universitarios. Analizar la relación entre el uso del teléfono celular y los problemas de salud físicos y psicoemocionales de estudiantes de enfermería universitarios. Metodología: Estudio cuantitativo no experimental, de corte transversal, descriptivo, prolectivo y correlacional. Se aplicó la encuesta "Escala de Uso Problemático del Teléfono Celular Modificada" a 265 estudiantes de enfermería de FES Iztacala. Resultados: El 57% de la población usa su teléfono celular para redes sociales. En los problemas físicos, 32% de estudiantes inician con problemas leves, 5% moderados y 1% graves. En los problemas psicoemocionales, 25% inician con problemas leves, 4% moderados y 2% graves. Hay asociación entre el uso y problemas de salud psicoemocionales (rp=0.659, p=0.000), al igual que con problemas de salud físicos (rp=0.541, p=0.000). Discusión: De acuerdo con Alonso-Fernández los síntomas se desarrollan más profundamente en la mente que en el cuerpo pues el tiempo de exposición afecta órganos y sistemas, principalmente el sistema nervioso implicando la psique. Conclusiones: El uso frecuente del teléfono celular está vinculado al acceso a internet, haciendo que el usuario pase más tiempo utilizando el dispositivo. Aunque son pocos los casos que presentan problemas, es indispensable que enfermería se involucre en estos tópicos, para el desarrollo de estrategias preventivas en la aparición de los problemas de salud asociados.

Introduction: Currently cellphones connect the users with the world through internet, giving them access to lots of information. In spite of all the benefits, there are health problems caused by the prolonged usage of it, they're manifested as anxiety, irritability, restlessness and physical discomfort; sensibility alterations, cervical injuries, visual problems and headache. Objectives: To analyze the existence of health problems associated to the cellphone usage among college nursing students. To analyze the relationship between the cellphone usage and physical and phycho-emotional health issues among college nursing students. Methodology: Prolective, correlational, descriptive, cross-sectional and non-experimental quantitative study. The survey "Escala de Uso Problemático del Teléfono Celular Modificada" was applied to 265 nursing students from FES Iztacala. Results: 57% of the population uses its phone for social networks. About physical problems, 32% of students are beginning to experience subtle problems, 5% moderate problems and 1% severe problems. About psycho-emotional issues, 25% are beginning to experience subtle issues, 4% moderate issues, and 2% severe issues. There's an association between cellphone usage and psycho-emotional health issues (rp=0.659, p=0.000) as well as with physical problems (rp=0.541, p=0.000). Discussion: According to Alonso-Fernández the symptoms are developed deeper on the mind than on the body due to exposition time the affects organs and systems, mainly the nervous system implying the psyche. Conclusions: The frequent usage of mobile phones is linked to the internet access, so the user spends more time using the device. Although the cases that present problems are few, it is essential for nursing to get involved in these topics in order to develop precautionary strategies in the appearance of related health issues.

Reflexões sobre um caso de síndrome de pânico enfocando os acontecimentos de corpo / Reflections on a case of panic disorder with focus on the corporal demeanors

O presente estudo propõe analisar os sintomas físicos manifestados na Síndrome de Pânico, enfocando-os não como reações fisiológicas, mas como eles se organizam, psiquicamente, ou seja, como "acontecimento corporal", no sentido tomado por Lacan, ao se referir clínica do real. Isso quer dizer que o sinthoma se utilizará do semblante como tentativa de articular o imaginário ao real. Miller fala sobre um acontecimento de gozo que denuncia a chegada do singular no sinthoma. Trata-se de um segmento da pesquisa psicanalítica desenvolvida para efeito de dissertação de mestrado no Programa de Pó-graduação em Psicologia Clínica da UNICAP, na qual utilizamos fragmentos de um caso clínico de um jovem do sexo masculino, casado, cujo diagnóstico psiquiátrico foi de Síndrome de Pânico, visando investigar as significações metapsicológicas dos sintomas físicos manifestados. Neste artigo, privilegiaremos nossas discussões em torno das significações dadas pelo paciente a seus sintomas corporais, distinguindo-as das manifestações fisiológicas desencadeadas pelo pânico, descritas na síndrome. As representações corporais foram entendidas como uma memória corporal que se manifesta na transferência. Nosso propósito foi mostrar nossa compreensão de como se organiza psiquicamente o acontecimento corporal nesse caso clínico, utilizando o método de interpretações proposto pela psicanálise. Como referencial teórico para discussão dessas questões, tomamos as contribuições freudianas pela ótica de Bastos, e também de autores contemporâneos que tratam do corpo na clínica, como Paul-Laurent Assoun, Piera Aulagnier, Ivanise Fontes e Maria Helena Fernandes. A análise de tais fragmentos revela que é possível identificar, por intermédio do acontecimento de corpo manifesto nos sintomas físicos do pânico, a organização da subjetividade nascente.

This study aims at analysing the physical symptoms manifested in by panic disorder - not only its merely physiological reactions - but also the way they are psychologically organized, that is to say, "the corporal demeanour" as viewed by Lacan, when referring to the clinic of real in the sinthome will make use of the semblance in an attempt to articulate the imaginary to the real. Millers refers to a jouissance which reveals the arrival of the singular into the sinthome. It is a segment of the psychoanalytic research, - carried out as master of Arts, Dissertation in the Graduate Program on Clinical Psychology at UNICAP - on which we will use fragments of a clinical case young man, married, whose psychiatric diagnosis is Panic Disorder. Our purpose is to search metapsychological meanings and the patient in relation to his corporal symptoms, by means of distinction between such meanings and the physiological manifestations caused by panic, described on the disorder. The corporal representations will be taken as a corporal memory that is revealed on the disorder. The corporal representations will be taken as a corporal memory that is revealed on the transfer. Our aims is to comprehend, with the analysis of the fragments of the studied case, how the corporal demeanour organizes itself psychologically, by means of the interpretation method suggested by psychoanalysis. As theoretical basis for discussion of such issues, we will consider Freud's ideas, according to Basto's view as well as contemporary authors who treat the body in clinic, like Paul-Laurent Assoun, Piera Aulagnier, Ivanise Fontes and Maria Helena Fernandes. The analysis of the fragments indicates that it is possible to identify the organization of the rising subjectiveness thorough body demeanor - present in the physical symptoms of panic.

A síndrome da fadiga crônica: apresentação e controvérsias / Chronic fatigue syndrome: presentation and controversies / El síndrome de la fatiga crónica: presentación y controversias

Apresentaremos o quadro da síndrome da fadiga crônica, emergente no final da década de 1980, nos Estados Unidos, Canadá e Reino Unido, no contexto de outras síndromes funcionais. Analisaremos o quadro clínico, os sintomas associados a ele e a flagrante dificuldade de encontrar um substrato anatomofisiológico para tal condição. Discutiremos, a partir do exemplo da síndrome da fadiga crônica, os efeitos de legitimidade/ilegitimidade da experiência do adoecimento decorrentes da distinção entre doença somática e doença mental. Analisaremos o processo de busca de explicações reduzidas ao aspecto somático da doença como reação para torná-la digna de apoio dos pares sociais e como forma de evitar associações do quadro com o que seria considerado uma doença psicossomática.

Chronic Fatigue Syndrome has emerged in the end of 1980, in developed countries as United States, Canada and United Kingdom. We aim to present the chronic fatigue syndrome in the context of other functional syndromes. We intend to analyze its symptoms, and the remarkable absence of an anatomophysiological finding related to this condition. We will discuss, since the distinction between somatic and mental disease, the legitimacy/illegitimacy effects suffered by the chronic fatigue syndrome patient. We will analyze the patient reaction of searching for a somatic explanation to the disease, as a way to turn the chronic fatigue syndrome into a reliable condition, and as a way of avoiding associations with psychosomatic diseases.

Este artículo presenta el síndrome de la fatiga crónica que emerge finales de la década de 1980 en Estados Unidos, Canadá e Reino Unido, en el contexto de otros síndromes funcionales. En el artículo serán analizados el cuadro clínico, los síntomas asociados a él y la dificultad flagrante de encontrar un substrato anátomo-fisológico para tal condición. Discutiremos, a partir del ejemplo del síndrome de fatiga crónica los efectos de legitimidad/ilegitimidad de la experiencia del enfermar resultante de la distinción entre enfermedad somática y mental. Analizaremos el proceso de búsqueda de explicaciones reducidas al aspecto somático de la enfermedad con el objetivo de hacerla digna de apoyo por los pares sociales y como forma de evitar asociaciones do cuadro con lo que sería considerado una enfermedad psicosomática.

Relación entre el consumo de tabaco, salud mental y malestares físicos en hombres trabajadores de una empresa textil mexicana / Relationship among current tobacco use, mental health and physical distress in male workers of a Mexican textile industry

Introduction Tobacco use is considered a worldwide public health problem because of the amount of death and disease it causes. The WHO reports that 30% of the adult population in the world are cigarette smokers, and that nearly five million of these will die within one year. Prospective studies performed by the WHO show that if current tobacco use continues, in 2020 there will be 8.4 million deaths due to tobacco-related diseases every year; seven out of 10 of these deaths will occur in emergent countries, like Mexico. More than 53000 tobacco users die every year in Mexico because of tobacco-related diseases, and at least 147 of these die daily. Data from the National Addictions Survey (NAS) 2002 showed that 26.4% of the people between 12 and 65 years old were active tobacco consumers; this amounted to nearly 14 million individuals. Of these, 7.1% were under 18 years old. The number of tobacco consumers in Mexico has increased from nine million in 1988 to 14 million in 2002. According to the NAS, 52% of the users smoke on a daily basis, and 61.4% of them began smoking when they were minors. To know the actual consumption levels, it is important to consider some factors: the number of cigarettes a person smokes, the different situations where a person smokes, and the social and physical consequences of smoking. Thus, it would be possible to develop a consumer classification (i. e. soft consumers, mild consumers, and hard consumers). There may be numerous causes for a person to be ill. When speaking about the harmful effects of tobacco use, the literature is clear in stating that these begin with the first cigarette smoked. However, it can take up to 30 years for a consumer to notice the damage on his health after his/her consumption began; but within the first ten years there are problems in lung function and in physical endurance. When a person starts smoking there are acute and unpleasant side effects that are rarely associated with smoked tobacco use. Consumption creates a tolerance which makes unpleasant effects to stop or fade away, giving place to pleasant sensations produced by nicotine; concentration improves and psychomotor skills, alert, and activation get better and there is a reduction in anxiety and stress. The relationship between tobacco use and mental health is evident at the level of the emotional outcomes of suffering a chronic illness, such as lung cancer. On the other hand, nicotine use has been related to a reduction in the severity of depression. Chemical alternatives for reducing consumption, based on the substance physical effects that promote addiction, have not proven to be effective so far. There is also evidence that consumers that fail in quitting smoking or people that have dependence problems with nicotine show a high prevalence of mayor depression when compared to non-dependent consumers. This association was direct with the severity of nicotine dependence. It also has been observed that smoking interferes often with psychological learning tools, mainly when consumption starts at very early ages. Emotional distress can produce low self-esteem and a lack of self-confidence. Therefore, the chances to begin tobacco consumption increase when it is used as a crutch to cope with social pressure and acceptance. Since tobacco use is a conduct that has shown to have serious repercussions on physical health and an important relationship with mental health in human beings, and is therefore a growing public health problem, the objective of this study is to explore a possible link among smoked tobacco consumption, mental health and physical problems in male workers from a textile factory. Method A non-probabilistic convenience sample was used in the study. Subjects voluntarily agreed to complete the questionnaire: 279 male workers were interviewed; 54% were between 18 and 27 years old and 23% were between 28 and 37. Most of them had studied junior high school or higher (74%) and 65% were in a serious relationship (married or living with a couple). Data about tobacco use were collected using a questionnaire with questions from the NAS 2002. To explore mental health the five-item Mental Health Inventory was used (MHI-5). As it is a self-answered screening test, it does not give a diagnosis, but it does allow establishing if subjects have symptoms of a probable mental health problem. Information about physical distress was collected through an 11-item somatization sub-scale from the Symptoms Check List-90 (SCL-90). The number of physical troubles that subjects reported during the last month was considered. All instruments have good levels of reliability and validity. Finally, several socio-demographic questions were included. The questionnaire was answered in groups inside a training room. Trained interviewers participated in the process of collecting information. Subjects' participation was voluntary and their verbal acceptation was obtained before answering the questionnaires. Anonymity and confidentiality were guaranteed. Workers were told that no information would be given to the union or business authorities, and those who asked for their results received them personally. Neither invasive procedures nor intervention techniques were used. The union authorities received a global report so they could acknowledge the importance of smoked tobacco and mental health-related problems among their workers. Statistical analyses were performed using SPSS 11.

Introducción El consumo de tabaco es considerado un problema de salud pública en todo el mundo debido a la cantidad de enfermedades y muertes relacionadas con su uso. La Organización Mundial de la Salud (OMS) reporta que 30% de los adultos son fumadores y, de éstos, aproximadamente cinco millones de personas morirán en un año. También se estima que para 2020 habrá 8.4 millones de muertes anuales por enfermedades relacionadas con el consumo de tabaco, de las cuales siete de cada 10 ocurrirán en países en vías de desarrollo, como México, donde más de 53 mil personas fumadoras mueren al año por enfermedades asociadas al tabaquismo y al menos 147 personas mueren diariamente. Por otro lado, en la bibliografía se ha encontrado que el daño en el organismo por fumar comienza desde el primer cigarro, que a los 10 años se presentan síntomas sutiles en la función pulmonar y disminución de la tolerancia al ejercicio, y que es entre 20 y 30 años después cuando los síntomas hacen a un fumador tomar conciencia del daño a su salud. En cuanto a la relación entre el uso de tabaco y la salud mental, ésta se evidencia por las consecuencias emocionales que conlleva padecer una enfermedad crónica. En este contexto, el objetivo del presente trabajo fue conocer la relación de problemas emocionales y malestares físicos con el consumo de tabaco en hombres trabajadores de una empresa textil mexicana. Método La muestra estuvo conformada por 279 sujetos que laboraban en una empresa textil, en su mayoría jóvenes entre 18 y 27 años (54.5%), con escolaridad de secundaria (59.3%) y casados o en unión libre (65.6%). El instrumento utilizado incluyó las escalas de salud mental (MHI-5), malestares físicos (SCL-90) y consumo de tabaco. La aplicación del instrumento se realizó de manera grupal dentro de la empresa textil en que laboraban los sujetos. Resultados No se encontraron diferencias significativas en cuanto a problemas de salud mental y síntomas físicos entre fumadores y no fumadores. Mediante un modelo de análisis de trayectorias, se analizó la relación existente entre síntomas físicos, problemas de salud mental e indicadores de consumo de tabaco. Se encontró así que el principal predictor de los síntomas físicos en fumadores es el tiempo que llevan consumiendo y que los síntomas físicos son un importante predictor de problemas de salud mental. Discusión Sin importar la cantidad de cigarrillos consumidos, la frecuencia de consumo ni otros indicadores de consumo elevado, el tiempo que se lleva consumiendo es un predictor importante del número de síntomas físicos que se manifiestan, lo que puede deberse a los efectos dañinos que tiene el consumo prolongado del tabaco. De este modo se confirma lo mencionado en otras investigaciones de que, después de los primeros 10 años de consumo, se presentan malestares físicos sutiles y que a lo largo de 20 o 30 años se presentaran malestares importantes. Si bien no se encontró una relación directa entre consumo de tabaco y salud mental, se puede sugerir una relación indirecta derivada de la influencia que tiene el consumo sobre el plano del bienestar físico. En este sentido es de esperarse que, a medida que se continúe consumiendo tabaco y los malestares físicos aumenten, también se incrementen los problemas de salud mental. Por otro lado, el modelo aquí presentado requiere ser completado incluyendo otras áreas que puedan influir sobre el bienestar físico y mental. Sin embargo, se logró evidenciar la importancia que tiene el consumo de tabaco sobre el malestar físico, a la vez que aumenta la probabilidad de que se presenten más problemas en la salud mental de la población consumidora.

Estrés laboral, afrontamiento, sensibilidad emocional y síntomas físicos y psicológicos en médicos venezolanos / Work stress, coping, emotional sensitivity, physical and phychological symtoms in Venezuelan physicians

La presente investigación tuvo como objetivo predecir los síntomas físicos y psicológicos percibidos de médicos venezolanos en función de su estrés laboral, estilos de afrontamiento, sensibilidad emocional y características demográficas. La muestra estuvo conformada por 130 médicos que trabajan en unidades críticas de hospitales públicos de Caracas (Venezuela), a quienes se evaluaron los factores psicosociales indicados para determinar el patrón de relación de los mismos y su capacidad de predecir el estatus de los síntomas físicos y psicológicos autoreportados por los galenos. Los resultados de las regresiones múltiples indicaron que el uso del afrontamiento emocional y el ser residente incrementan los niveles de síntomas físicos; adicionalmente, los síntomas psicológicos fueron predichos por el uso del afrontamiento emocional, la condición de ser médico residente, mujer y el poco uso del desapego emocional. Por su parte, la característica de personalidad de mayor presencia en los médicos es la sensibilidad interpersonal positiva, involucrando la expresión y manifestación de sentimientos positivos. Finalmente, el modelo de estrés laboral de Karasek y Theorell permitió la clasificación de los profesionales de la medicina venezolanos en el cuadrante de aprendizaje activo.

This research aimed at predicting the perceived health of Venezuelan physicians based on their work stress, coping styles, emotional sensitivity and sociodemographic characteristics. Sample was 130 physicians working in critical units of public hospitals in Caracas, Venezuela, who were evaluated on the mentioned psychosocial factors in order to determine their interrelationship and their ability to predict the health status of the physicians. Results from multiple regressions analyses suggested that physical symtoms are predicted for using emotional coping and being resident. Also, using emotional coping, but low emotional detachment, being medical resident and woman, predicted increased psychological symptoms. On the other side, the positive interpersonal sensitivity was the most consistent personality characteristic of the physicians, involving the expression of positive affects. Finally, the Karasek and Theorell´s model of work stress allowed classifying the Venezuelan physicians on the active learning block.

Trastorno depresivo mayor en México: la relación entre la intensidad de la depresión, los síntomas físicos dolorosos y la calidad de vida

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SUMMARY Background: Major Depressive Disorder (MDD) is a disease associated to emotional, vegetative and physical symptoms, including for the latter those pain-related symptoms. MDD has a high prevalence rate with a substantial burden of illness, and it expected that by 2020 it will become the second cause of world disability. The diagnosis of MDD is difficult due to the high prevalence of painful physical symptoms, and also due to the fact these symptoms are more evident that the embedded emotional ones. Over 76% of patients with MDD, report painful physical symptoms observed, like headache, abdominal pain, back pain and unspecific-located pain; observing these symptoms can even predict depression severity. In addition, the likelihood of psychiatric disease increases, importantly, with the number of physical symptoms observed; moreover, the remission of physical symptoms predicts the complete remission in MDD. We present an observational, prospective study to examine the clinical profile of Mexican outpatients suffering MDD and determine the relationship between depression severity, painful physical symptoms in quality of life and depression. Methods: Adult patients with current episodes of MDD, treated with antidepressants were included. MDD was defined according to the criteria of the Statistical Manual of Mental Disorders - 4th Edition (DSM-IV) or in the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Patients should have been free of depression symptoms prior to the current episode for at least 2 months. Duration of current episode should not exceed two years. Treatment-resistant patients and those with other psychiatric diagnosis were excluded. Treatment-resistance was defined as: a) a failure to respond to treatment when two different antidepressants were employed at therapeutic doses for at least four weeks each, b) when the subject was previously treated with IMAO inhibitors, c) when electro-convulsive therapy (ECT) was previously employed. Other exclusion criteria comprise previous or current diagnosis of schizophrenia, schizophreniform or schizoaffective disorder, bipolar disorder, dementia or mental impairment. Patients were selected in 34 centers in Mexico. Patients were classified according to the presence (SFD+) or absence (SFD-) of painful physical symptoms using the Somatic Symptom Inventory (SSI); SFD+ was defined as scores ≥ 2 for the pain-related items in the SSI (items 2, 3, 9, 14, 19, 27 and 28). Visual Analogue Scale (VAS) quantified pain severity (cervical pain, headache, back pain, shoulder pain, interference of pain in daily activities and vigil-time with pain). HAMD17 and CGI-S determined depression severity, while the Quality of Life in Depression Scale (QLDS) quantified subjective well-being. Linear regression models were employed to compare groups for VAS, HAMD17, CGI-S, and QLDS, to fit the confusions or clinical predictors when needed. Proportions between groups were established with Fisher exact test or logistic regression. Significance levels were established at 0.005 due to the observational nature of the study. In the result tables, standard deviation (SD) is reported as a variation around the mean value as Mean ± SD, and 95% confidence intervals are denoted 95% IC. Results: A total of 313 patients were enrolled in the study. All of the enrolled patients were Mexican, almost them were women and had at least a previous MDD episode. Painful physical symptoms were reported by 73.7% of patients, these patients were classified into the SFD+ group. Neither statistical nor clinical significant differences between the SFD+ and SFD- groups were found when analyzing socio-demographic variables (age, gender, ethnical origin) and disease history variables (number of previous episodes of MDD, in the last 24 months, duration of current episode). At baseline, patients had a CGI-S mean score of 4.6 and HAMD17 of 26.3. HAMD17 mean score (27.1) in SFD+ patients was significantly higher (p<0.0001) than the SFD- patients (23.8), but nonsignificant differences between groups were found for the subscales central, Maier & retard. CGI-S scores were similar between SFD+ and SFD-; 4.6 and 4.5 respectively (p>0.05). Prevalent painful physical symptoms were also the most painful, when a five-point scale was employed to measure severity, and comprised muscular pain (84.9%), cervical pain (84.2%) and headache (83.5%). SFD+ patients had higher pain severity in all VAS scales (p<0.0001), with perceived severity scores twice as large when compared to SFDgroup. In particular, the global pain VAS reported average values of 49.0 and 19.7 for the SFD+ and SFD- groups respectively. Patients came to the first psychiatric consultation treated with psychotherapy (27.9%), antidepressants (37.3%), anxiolytics (28.6%) and analgesics (9.7%); more than 50% of all patients were not taking any drugs or receiving psychotherapy for treatment of MDD at baseline. Analgesics were used only by 9.7% of patients for the treatment of painful physical symptoms in their current MDD episode. No significant differences between groups were found when comparing the use of psychotherapy, antidepressants, anxiolytics, antipsychotics, mood stabilizers or analgesics. Quality of life was poor for all patients, but significantly worse in the SFD+ group than in the SFD- group (QLDS scores of 23.2 and 20.0 respectively, p<0.001). Discussion: The diagnosis and symptoms manifestation can be influenced by local socio-cultural factors, in particular cultural differences are associated with the prevalence of painful physical symptoms, but this finding is not consistent. The results of this study can be extrapolated to the MDD Mexican population, as selection criteria comprised only operative diagnosis criteria, and not enrollment into the study took place due to the presence of painful physical symptoms. Patients included into the study presented a moderate to severe disease as measured with the HAMD17 scores. The high prevalence of painful physical symptoms in patients with depression was confirmed in this study; it has been reported the patients report pain-related symptoms as the main (even the only) symptom when consulting general practitioners. Painful physical symptoms in MDD include headache, cervical pain, back pain or neck pain; the presence of painful physical symptoms in depression is associated to higher intakes medication, but in this study more than 50% of subjects were not receiving any treatment, including psychotherapy. The treatment of MDD is by no means optimal, as only 30%- 40% of these patients reach complete remission of symptoms with their first antidepressant. Psychological symptoms respond to antidepressant treatment, but in general, this is not the case for the physical symptoms. The lack of efficacy can be explained as a failure in the treatment of these painful physical symptoms. Resolving these symptoms is even a predictor for the complete remission of MDD; the evidence might suggest that treatment of emotional and physical manifestations of depression could improve successful-treatment rates. Conclusion: As found in other reports, a high prevalence of painful physical symptoms was found in MDD patients. Increase in pain severity is associated with higher HAMD17 scores but not CGI-S scores; this discrepancy in the final rates obtained with both scales suggests that both emotional and physical dimensions of MDD should be considered when the clinical assessment is performed. We concluded that clinical judgment of Mexican psychiatrists differs between their global impression and a semi-structured interview in the same patient and therefore is fundamental that the clinical evaluation consists of both emotional and physical manifestations as important components of MDD.