Mina P Dahli1, Jūratė Šaltytė-Benth2,3, Ole R Haavet1, Torleif Ruud2,4, Mette Brekke1,5. 1. Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. 2. Division of Health Services Research and Psychiatry, Institute for Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway. 3. Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway. 4. Mental Health Services, Akershus University Hospital, Lørenskog, Norway. 5. Department of General Practice, Generap Practice Research Unit, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Abstract
BACKGROUND: Patients with mental health problems often present with somatic symptoms when visiting their general practitioner (GP). Somatic presentations may challenge correct diagnosing of mental health disorders in general practice, where most of these disorders are treated. OBJECTIVE: Explore the associations between common psychological diagnoses and somatic symptom diagnoses in Norwegian urban general practice. METHODS: A retrospective cohort study including electronic medical data from 15 750 patients aged 16-65 years from 35 GPs in six GP offices in Oslo, Norway, during 12 months in 2014-2015. We explored prevalences and associations between anxiety-, depression-, and stress-related diagnoses, and somatic symptom diagnoses. RESULTS: Patients with anxiety-, depression- and stress-related diagnoses had a mean number of 2.9±3.6 somatic symptom diagnoses during the 12 months, compared to 1.9±2.5 for patients without any psychological diagnoses (P < 0.001). The mean number of somatic symptoms was significantly higher for the different psychological diagnoses viewed separately, for both sexes and different age groups. There was an increase in probability for anxiety, depression, or stress-related diagnoses with an increasing number of somatic symptom diagnoses during the 12 months. We found a significant increase in somatic symptom diagnoses from ICPC-2 chapters: General and unspecified, digestive, cardiovascular, musculoskeletal, neurological, urological, female genital disorders and social problems. Associated symptom patterns were different for each of the included psychological diagnoses. CONCLUSIONS: This study shows that patients with anxiety, depression- and stress-related diagnoses present with increased and characteristic somatic symptoms compared to patients without these diagnoses in general practice.
BACKGROUND: Patients with mental health problems often present with somatic symptoms when visiting their general practitioner (GP). Somatic presentations may challenge correct diagnosing of mental health disorders in general practice, where most of these disorders are treated. OBJECTIVE: Explore the associations between common psychological diagnoses and somatic symptom diagnoses in Norwegian urban general practice. METHODS: A retrospective cohort study including electronic medical data from 15 750 patients aged 16-65 years from 35 GPs in six GP offices in Oslo, Norway, during 12 months in 2014-2015. We explored prevalences and associations between anxiety-, depression-, and stress-related diagnoses, and somatic symptom diagnoses. RESULTS: Patients with anxiety-, depression- and stress-related diagnoses had a mean number of 2.9±3.6 somatic symptom diagnoses during the 12 months, compared to 1.9±2.5 for patients without any psychological diagnoses (P < 0.001). The mean number of somatic symptoms was significantly higher for the different psychological diagnoses viewed separately, for both sexes and different age groups. There was an increase in probability for anxiety, depression, or stress-related diagnoses with an increasing number of somatic symptom diagnoses during the 12 months. We found a significant increase in somatic symptom diagnoses from ICPC-2 chapters: General and unspecified, digestive, cardiovascular, musculoskeletal, neurological, urological, female genital disorders and social problems. Associated symptom patterns were different for each of the included psychological diagnoses. CONCLUSIONS: This study shows that patients with anxiety, depression- and stress-related diagnoses present with increased and characteristic somatic symptoms compared to patients without these diagnoses in general practice.