title: Comorbid painful physical symptoms and anxiety: prevalence, work loss and help-seeking.
abstract: BACKGROUND
  There is evidence that painful physical symptoms (PPS) are increased in patients with anxiety disorder (AD). This survey reports the 12-month prevalence and sociodemographic characteristics of PPS in subjects with and without AD, taking into account somatic comorbidity. In addition, the impact of PPS on work loss days (WLDs) and help-seeking was examined.
  
  
  METHODS
  In a cross-sectional, population-based study, a representative random sample of non-institutionalised adults from Belgium, France, Germany, Italy, The Netherlands and Spain (N=21,425) was interviewed using the World Mental Health Composite Diagnostic Interview (CIDI 3.0 of the WHO). 8296 respondents provided data on the occurrence of PPS, from which 5489 respondents reported the number of work loss days.
  
  
  RESULTS
  PPS were reported by 28% of respondents without AD and by 45% in those with AD. Female gender, higher age and lower educational level were predictive of PPS. No additive effect of AD and PPS was found on the WLD score, neither did the presence or not of a comorbid somatic disorder change the findings. Finally, respondents with both AD and PPS had numerically higher rates of help-seeking for emotional reasons (20.8% vs. 15.0% for respondents with AD but not PPS) and delayed their help-seeking for a numerically shorter period of time (289 vs. 413 days, respectively).
  
  
  CONCLUSIONS
  The most important limitation of this study was its reliance on self-reported data about somatic disorders.
  
  
  CONCLUSIONS
  Approximately 45% of persons with anxiety disorder also reported the presence of PPS. No additive effect of AD and PPS was found on the WLD score, and the presence of PPS in AD does not delay help-seeking for emotional problems.
authors.affiliation: Department of Psychiatry, University Hospital Gasthuisberg, Leuven, Belgium. koen.demyttenaere@med.kuleuven.be <koen.demyttenaere@med.kuleuven.be>
authors.forename: Koen
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: Anke
authors.initials: A
authors.lastname: Bonnewyn
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Ron
authors.initials: R
authors.lastname: De Graaf
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000453:epidemiology*; D055815:Young Adult