A study from the Netherlands has shown that ‘somatoform’, or ‘psychosomatic’, disorders are among the most common psychiatric disorders found in general practice. At least one out of six patients seen by a general practitioner has a somatoform disorder.
Patients with somatoform disorders have physical symptoms for which there is no medical explanation, such as headaches, stomach pains or fatigue. Some research has reported a prevalence of somatoform disorders as high as 30.3%. These medically unexplained symptoms are chronic, and often occur together with anxiety and depression.
The aims of this study, published in the June issue of the British Journal of Psychiatry, were to estimate the prevalence of, and impairment associated with, somatoform disorders; and to assess how often they occur with anxiety and depressive disorders.
The study took place in eight university-affiliated general practices in the Netherlands. 1046 consecutive patients aged between 25-80 completed two sets of questionnaires. In the initial stage, screening questionnaires were used to identify high-risk patients. In the second stage, all high-risk patients, and a sample of 15% of the low risk patients, were invited for a psychiatric diagnostic interview.
After a follow-up of six months, participants with a somatoform disorder will be included in a subsequent controlled treatment study of cognitive behavioural therapy (CBT) given by their own general practitioner.
It was found that the prevalence of somatoform disorders was 16.1%. When disorders with only mild impairment were included, the prevalence increased to 21.9%.
The prevalence of current anxiety disorders was 5.5%, and of current depressive disorders 4.1%. More than half the patients with an anxiety or depressive disorder also had a somatoform disorder.
The likelihood of somatoform disorders occurring together with anxiety and depressive disorders was 3.3 times higher than could be expected by chance.
All patients were, by definition, at least moderately impaired, owing to their symptoms. Somatoform disorders, as well as anxiety and depressive disorders, were associated with substantial functional impairment among patients.
In patients with both somatoform and anxiety/depression, the symptoms and functional limitations increased proportionally, which resulted in a substantially higher burden of illness for patients with both types of disorder.
The authors of the study comment that in order to engage patients in an effective psychological treatment, it is important for general practitioners to be able to recognise somatoform symptoms.
For further information or a press copy of the full article, contact Deborah Hart or Thomas Kennedy in the External Affairs Department. Tel: 020 7235 2351 exts. 127 or 154. E-mail: [email protected].