The aim of this study by researchers from Melbourne was to measure the prevalence of somatisation (multiple somatic symptoms and hypochondriasis) among Australian general practice attendees, its recognition by general practitioners, and its relationship with symptoms of depression and anxiety. It consisted of self-reported questionnaires completed by 10,507 consecutive patients aged >=18 years attending 340 GPs enrolled in a 6-hour national mental health program of continuing professional development who accepted invitations to participate; audit form completed by GPs for each patient during the period March 2004 to December 2006. The main outcome measures were somatic symptom severity (measured with the 15-item Patient Health Questionnaire [PHQ-15
18.5% of patients were classified as somatisers and 9.5% as probable cases of depression or anxiety. While 29.6% of somatisers had high anxiety or depression scores, 57.9% of people with anxiety or depression were also somatisers. Sex and age asserted significant but weak effects on psychometric scores. GPs identified somatic complaints as "mostly explained by a psychological disturbance" in 25.1% of somatisers.
The researchers concluded: "Somatisation is common in general practice, and more prevalent than depression or anxiety. While a minority of somatisers have significant anxiety and depression, most patients with depression and anxiety have a significant degree of somatisation. Recognition of depression and anxiety can be hindered by a somatic presentation and attribution. On the other hand, managing somatisation does not just involve recognising depression and anxiety, but also dealing with the health anxieties that underpin hypochondriasis."
This is a major health burden and cost and particularly important in general practice.
Medical Journal of Australia 17 Nov 2008; 189 (10): 560- 564 © The Medical Journal of Australia
Somatic symptoms, hypochondriasis and psychological distress: a study of somatisation in Australian general practice. David M Clarke, Leon Piterman, Claire J Byrne and David W Austin. Correspondence to: David M Clarke: david.clarke@med.monash.edu.au
Category: P. Psychological Keywords: somatic symptoms, somatisation, hypochondriasis, distress, Australia, general practice, self reported questionnaires, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 26 November 2008
