Lane R S, Barsky A J, Goodson J D
Department of Medicine, Massachusetts General Hospital, Boston 02114.
J Gen Intern Med. 1988 Nov-Dec;3(6):540-6. doi: 10.1007/BF02596095.
Ambulatory patients with upper respiratory infection were studied to determine the relative contributions made by tissue pathology, psychologic and perceptual attributes, and demographic characteristics to reported discomfort and disability. Patients (n = 115) attending a medical walk-in clinic completed self-report questionnaires to assess somatization, anxiety, depression, hostility, amplification, discomfort, disability, and demographic characteristics. Clinicians rated the extent of disease apparent on physical examination. Using stepwise multiple regression, demographic factors and physical findings explained 25% of the variance in reported discomfort. The addition of somatization scores increased the variance explained to 49%. The best model, including somatization and amplification, accounted for 54% of the variance. A model composed of demographic characteristics, physical findings, and somatization accounted for 25% of the variance in reported disability. The authors conclude that psychologic variables are important in the experience of discomfort, even after the extent of physical disease and demographic characteristics have been taken into account.
