Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion.
This study was undertaken to assess recognition of medically unexplained physical symptoms by general practitioners (GPs), and the feasibility of using a screening procedure based on validated self-report questionnaires. GPs identified unexplained physical symptoms as the main clinical problem for 19% of attending patients. Screening instruments identified 35% of patients as having multiple unexplained physical symptoms, of whom 5% were probable cases of somatization disorder. Nine percent of attending patients reported high levels of health anxiety. Twenty percent were probable cases of mood disorder: in half of these, psychological symptoms were not documented in the casenotes. Patients with more somatic symptoms and higher health anxiety were more likely to be recognized by the GP: higher levels of mood symptoms did not predict recognition. The screening procedure used in this study shows promise and merits further investigation.
Peveler
R
R
Psychiatry Group, University of Southampton, UK.
Kilkenny
L
L
Kinmonth
A L
AL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D001294:Attitude to Health; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D003955:Diagnostic Tests, Routine / Q000379:methods; D004739:England / Q000453:epidemiology; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012494:Sampling Studies; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology