title: The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data.
abstract: OBJECTIVE
  The present study investigates the association of modern health worries (MHW) with self-reported as well as general practitioner (GP)-registered non-specific physical symptoms (NSPS), medication use, alternative therapy consultations, sleep quality and quality of life. The interrelation between MHW, general environmental sensitivity and the aforementioned outcomes is also explored.
  
  
  METHODS
  Self-reported questionnaires and data from electronic medical records from 21 general practices in The Netherlands were combined in a sample of 5933 adult participants.
  
  
  RESULTS
  The majority of the participants reported increased worries about potential health effects from environmental exposures. The highest worry scores were reported by people who perceived themselves as more vulnerable to environmental stressors. After adjustment for socio-demographic characteristics and diagnosed psychiatric morbidity, higher MHW were significantly associated with increased self-reported prevalence and duration of NSPS, symptom-related healthcare utilization, GP-registered NSPS, alternative therapy consultations and lower sleep quality and quality of life. These associations were statistically mediated by perceived environmental sensitivity. No association was observed between worries and GP-registered medication prescriptions.
  
  
  CONCLUSIONS
  Modern health worries are very common in the general population. They are associated with self-reported as well as clinically defined NSPS and as such might play a key role in the process of developing and maintaining environmental sensitivities and related symptoms. A large cross-cultural longitudinal study would help to determine important aspects such as temporal precedence and stability of MHW and the relevant psychosocial context within which symptomatic conditions occur.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. Electronic address: C.Baliatsas@nivel.nl.
authors.forename: Christos
authors.initials: C
authors.lastname: Baliatsas
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: van Kamp
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Mariëtte
authors.initials: M
authors.lastname: Hooiveld
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Lebret
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Joris
authors.initials: J
authors.lastname: Yzermans
mesh_terms: D000328:Adult; D000529:Complementary Therapies; D004363:Drug Utilization; D057286:Electronic Health Records; D018876:Environmental Illness / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012017:Referral and Consultation; D057566:Self Report; D012890:Sleep; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Environmental sensitivity; General practice; Idiopathic environmental intolerance; Medically unexplained symptoms; Modern health worries