By Will Boggs, MD

NEW YORK, Mar 27 (Reuters Health) - Patients who tell their doctor they're feeling stressed out and have a long list of health complaints may be suffering from depression, anxiety or other emotional problems, researchers report.

"Mental disorders are very common," Dr. Jeffrey L. Jackson told Reuters Health. "When present they frequently manifest themselves, not as psychological symptoms, but as physical ones."

And because doctors often do not pick up on such emotional problems--which patients may be reluctant to talk about, or may even be unaware of--many people do not get the help they truly need.

"Patients who present with physical complaints as a manifestation of depression or anxiety will have significant improvement in their physical symptom when the mental disorder is recognized and appropriately treated," Jackson told Reuters Health.

In a new study, Jackson and colleagues from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, tried to find subtle clues that might help doctors pick up on patients suffering from anxiety or depression.

In their study, the researchers gave 250 clinic patients aged 18 to 92 a questionnaire. The investigators found that more than one quarter of their patients were experiencing depression, anxiety or some other emotional problems. One patient in 10 had at least two emotional problems, the authors note.

Those patients who had experienced a recent stress were nearly seven times more likely than others to have an underlying mental disorder, according to the report in the March 26th issue of the Archives of Internal Medicine. Those with at least six physical complaints faced four times the usual risk of having emotional problems.

Just the feeling of having less than very good overall health more than doubled the risk of having mental problems, the report indicates.

Any combination of these factors heightened the risk of having emotional problems, Jackson's team notes, so that 72% of patients with all three predictors had some kind of mental disorder.

But mental disorders cannot be diagnosed simply based on these three clues. "That's also not its purpose," Jackson said. "The real purpose of this--and previous other studies I've done--is to show that there are clinical cues that clinicians can use which should trigger doing a formal screen for a mental disorder."

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• Depression
• Stress