Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice.
BACKGROUND
Musculoskeletal illness is a common cause of absenteeism from work, workers' compensation, and disability retirement, and accounts for 9.3% to 17% of patient contacts in general practice. To understand the increase in self-reported musculoskeletal illness and to improve treatment and prevention, it is important to know which factors to target when dealing with these patients.


OBJECTIVE
To investigate whether the prognosis for patients with musculoskeletal illness referred to physiotherapy from general practice can be predicted by the presence of psychological distress and somatisation identified by a general practitioner (GP) and standard questionnaires.


METHODS
A multi-practice survey based on questionnaires (index and three-month follow-up). Nine hundred and five consecutive patients referred to physiotherapy from 124 different general practices in Denmark were included. Outcome measures were physical health change, sick leave, patient self-rated improvement, and change in use of medication.


RESULTS
Psychological distress and somatisation rated by both GPs and standard questionnaires acted with almost no exception as significant predictors of all four outcome measures.


CONCLUSIONS
Psychological distress and somatisation are important factors when considering preventive initiatives and treatment of patients with musculoskeletal illness in general practice.
Jørgensen
C K
CK
Department of General Practice, University of Aarhus, Denmark. ckj@alm.au.dk
Fink
P
P
Olesen
F
F
D000041:Absenteeism; D005194:Family Practice; D006801:Humans; D016015:Logistic Models; D009140:Musculoskeletal Diseases / Q000150:complications / Q000523:psychology*; D011379:Prognosis; D013001:Somatoform Disorders / Q000209:etiology*; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires