The reporting of specific physical symptoms for mental distress in general practice.
OBJECTIVE
Do patients report specific physical symptoms in the presence of mental distress, taking into account the presence of somatic disease?


METHODS
Cross-sectional data were collected from 1458 participants in eight general practices in The Netherlands. Electronic patient records provided information on somatic disease. Questionnaires included the Hospital Anxiety and Depression Scale (HADS) to measure mental distress and the Physical Symptom Checklist (PSC).


RESULTS
Patients reporting mental distress reported all types of physical symptoms more often than did patients without mental distress. Multivariate analyses in women, corrected for the presence of somatic disease, did not substantially change the univariate pattern. Odds ratios were particularly high (>6) for feeling tired or having low energy, fatigue without exertion and forgetfulness.


CONCLUSIONS
It is the level of mental distress rather than gender or somatic disease that accounts for the reporting of any physical symptom. Fatigue might be an exception, but here, the classification as "physical" rather then "mental" is somewhat ambiguous.
de Waal
Margot W M
MW
Department of General Practice and Nursing Home Medicine, Leiden University Medical Center, The Netherlands. m.w.m.de_Waal@lumc.nl
Arnold
Ingrid A
IA
Spinhoven
Philip
P
Eekhof
Just A H
JA
van Hemert
Albert M
AM
D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012680:Sensitivity and Specificity; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires