Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Division of Health Services Research and Psychiatry, Institute for Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.
Fam Pract. 2021 Nov 24;38(6):766-772. doi: 10.1093/fampra/cmab038.
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.
Explore the associations between common psychological diagnoses and somatic symptom diagnoses in Norwegian urban general practice.
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.
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.
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.
当患有精神健康问题的患者去看全科医生（GP）时，他们通常会出现躯体症状。这些躯体表现可能会对精神健康障碍的正确诊断造成挑战，因为这些障碍大多在全科医学中进行治疗。
探讨挪威城市全科医学中常见心理诊断与躯体症状诊断之间的关联。
这是一项回顾性队列研究，纳入了 2014 年至 2015 年期间挪威奥斯陆 35 名全科医生的 6 个全科诊所中 15750 名年龄在 16-65 岁的患者的电子病历数据。我们探讨了焦虑症、抑郁症和应激相关诊断与躯体症状诊断之间的患病率和关联。
在 12 个月期间，患有焦虑症、抑郁症和应激相关诊断的患者平均有 2.9±3.6 种躯体症状诊断，而没有任何心理诊断的患者为 1.9±2.5（P<0.001）。分别观察不同的心理诊断时，男性和女性以及不同年龄组的患者的躯体症状数量均显著更高。随着 12 个月期间躯体症状诊断数量的增加，焦虑症、抑郁症或应激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数量显著增加：一般和未特指、消化、心血管、肌肉骨骼、神经、泌尿系统、女性生殖系统疾病和社会问题。与纳入的每个心理诊断相关的症状模式不同。
本研究表明，与没有这些诊断的患者相比，患有焦虑症、抑郁症和应激相关诊断的患者在全科医学中表现出更多且具有特征性的躯体症状。
