The prevalence of medically unexplained symptoms in primary care

Abstract

Objective: There is only a small number of studies dealing with the prevalence of medically unexplained symptoms and somatoform disorder in German primary care practices. Therefore, we aimed to study the prevalence of medically unexplained symptoms and the prevalences and comorbidities of somatoform and other mental disorders.

Method: In the initial stage of a two-stage prevalence study, 620 consecutive patients were first screened with a PHQ-15 questionnaire. In the second stage, 308 selected persons were then interviewed in detail.

Results: Medically unexplained symptoms made up two-thirds of all reported symptoms with women, younger persons, and non-native speakers having the highest rates. The 12-months prevalences of somatoform disorders was 22.9%, for affective disorders it was 12.4%, and for anxiety disorders it was 11.4%. Somatoform disorder was comorbid with at least one other mental disorder in 43.2% of the cases. Most frequently, somatoform disorder was comorbid with anxiety or depression. 37.1% of the patients had a mental disorder.

Conclusion: Somatoform and other mental disorders are highly common in primary care. In order to support an adequate management of mental and somatoform disorders, general practitioners should consider the influences of gender and cultural background on the development of a mental disorder.