In some cultures, including ours, direct explanation of inner psychic world is inhibited and stigmatized, therefore finding alternative modes of expression.

The aim of this cross-sectional study was to reach to an estimation of the frequency of somatization in the depressed patients.

500 patients with major depressive disorder referred to the outpatient clinic of Shiraz University of Medical Sciences were recruited and diagnosed based on DSM-IV-TR. Through psychiatric interview, we assessed the presenting complaints of these patients. the presenting symptoms were divided into three main categories namely: mental symptoms, pain, and physical symptoms other than pain. Statistical analysis (chi-square and logistic regression) were performed to assess the relationship between presenting symptoms and some demographic variables such as age, gender, marital status, educational level and cultural background.

Physical symptoms other than pain in 193 (38.6%), mental symptoms in 186 (37.2%) and pain in 121 (24.2%) of the patients were seen. Pain and physical complaints were more common in patients with rural cultural background, lower education, women and the married ones. Headache (15.2%), irritability (10.6%) and pain in other areas of the body (10.4%) were the most frequent chief complaints the patients had stated. the symptoms of hypochondriasis, suicidal idea, crying, irritability and insomnia were significantly associated with the complaint of somatization.

Somatic symptoms, especially pain, have a significant weight in the chief complaints of depressed patients. Physicians need to pay proper attention to this important issue in order to better understand their patients.