The Mediating Role of Somatic Symptoms in the Effect of Depression on Problem-Solving Skills

Background: Major depressive disorder (MDD) is a serious mental disorder that is common worldwide and is associated with somatic symptoms. Cognitive and behavioral problems caused by depression can negatively affect problem-solving skills, and somatic symptoms related to depression can intensify this effect. Although the relationship between depression and problem-solving skills has been investigated in the literature, the mediating role of somatic symptoms in this relationship has not been sufficiently examined. This study aims to investigate the effect of somatic symptoms on problem-solving skills in
patients with depression.

Methods: This study included 200 patients diagnosed with MDD according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria who applied to the psychiatry outpatient clinic of Recep Tayyip Erdogan University Training and Research Hospital between March 2021 and March 2022. The sociodemographic data form, Structured Clinical Interview for DSM-5 Disorders Clinician Version, Hamilton Depression Rating Scale, Beck Depression Inventory, Problem Solving Inventory, and Somatosensory Amplification Scale were administered to the participants. The obtained data were analyzed using the SPSS v26.0 program.

Results: Around 111 (55.5%) of the participants had somatic symptoms, and depression levels were
found to be higher in this group. Somatic symptoms were more common in women and older individuals. Participants with somatic symptoms exhibited more hasty and avoidant approaches to problem-solving skills and used thoughtful, evaluative, planned, and self-confident approaches less. In addition, it was observed that problem-solving skills improved with increasing education levels. It was determined that somatic symptoms had a mediating role in the effect of depression on problem-solving skills.

Conclusion: This study is the first in the literature to evaluate the relationship between somatic
symptoms and problem-solving skills in patients with depression. This study shows that somatic
symptoms have a negative effect on problem-solving skills in depressed individuals. The presence
of somatic symptoms leads to the use of less effective strategies in the problem-solving process,
which can exacerbate the cognitive symptoms of depression. Approaches aimed at reducing somatic
symptoms in treatment processes can strengthen the problem-solving skills of depressed individuals
and improve treatment outcomes.

Cite this article as: Sonmez D, Bahceci B. The mediating role of somatic symptoms in the effect of depression on problem-solving skills. Psychiatry Clin Psychopharmacol. Published online April 16, 2025. doi: 10.5152/pcp.2025.241056