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.

中文翻译：

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躯体症状和与常见心理诊断的关联：来自挪威城市一般实践的回顾性队列研究

摘要

背景

有精神健康问题的患者在拜访全科医生 (GP) 时通常会出现躯体症状。躯体表现可能会挑战在一般实践中对精神健康障碍的正确诊断，其中大多数这些疾病都得到治疗。

客观的

探索挪威城市一般实践中常见的心理诊断和躯体症状诊断之间的关联。

方法

一项回顾性队列研究，包括 2014-2015 年 12 个月内来自挪威奥斯陆六个全科医生办公室的 35 名全科医生的 15750 名 16-65 岁患者的电子医疗数据。我们探讨了焦虑、抑郁和压力相关诊断与躯体症状诊断之间的普遍性和关联性。

结果

在 12 个月内，患有焦虑、抑郁和压力相关诊断的患者平均诊断出 2.9±3.6 次躯体症状，而没有任何心理诊断的患者平均诊断为 1.9±2.5 次（P< 0.001)。对于不同性别和不同年龄组的不同心理诊断，躯体症状的平均数量显着更高。在 12 个月期间，随着躯体症状诊断数量的增加，焦虑、抑郁或压力相关诊断的可能性增加。我们发现 ICPC-2 章节中的躯体症状诊断显着增加：一般和未指定、消化、心血管、肌肉骨骼、神经系统、泌尿系统、女性生殖器疾病和社会问题。每种包含的心理诊断的相关症状模式都不同。

结论

这项研究表明，在一般实践中，与没有这些诊断的患者相比，患有焦虑、抑郁和压力相关诊断的患者表现出更多的特征性躯体症状。