Clinical characteristics of somatization symptoms of Chinese outpatients in the Department of Cardiology

Abstract

Somatization symptoms are common in patients with cardiovascular disease (CVD). However, it is challenging to improve these symptoms as the cardiologists in general hospitals, whom these patients sought medical attention from, are imperceptible to signs of psychological disorders, thereby leading to unnecessarily high medical costs and failure of improving the symptoms. Therefore, this study aimed to explore the clinical characteristics and factors that affect somatization symptoms in Chinese outpatients with CVD, providing results that could benefit the improvement of diagnosis and intervention of psychological disorders in the future. We conducted a cross-sectional and observational study in a tertiary general hospital in Hunan, China, from August 2020 to July 2021. Patient health questionnaire-15 (PHQ-15), general anxiety disorder-7 (GAD-7), PHQ-9, and a general demographic data questionnaire were used to screen outpatients for suspected psychiatric disorders. Of the 808 patients in this study, somatization symptoms occurred in 93.1% (752/808) of the sample. In patients with somatization symptoms, the mean total score on the PHQ-15 was 8.54 ± 2.67, and the prevalence of anxiety or depression was 78.7%. The PHQ-15 symptom items with a positive rate of >50% were sleep disorders, chest pain, headache, dyspnea, palpitation, and dizziness. The severity of somatization symptoms differed based on gender (P = 0.0341) and past hospitalization history (P = 0.023). In addition, there was a correlation between somatization symptoms and scores on the GAD-7 (P = 0.0282) and PHQ-9 scales (P = 0.0011). Linear correlation analysis found that PHQ-15 scores were significantly linked to GAD-7 (r = 0.4787, P < 0.001) and PHQ-9 scores (r = 0.5141, P < 0.001) in patients with somatization symptoms. Stepwise logistic regression analysis indicated that female gender, PHQ-9, and GAD-7 scores could positively predict somatization symptoms. In conclusion, somatization symptoms are prevalence in Chinese outpatients treated in the cardiology department. Anxiety, depression, and gender are the main factors affecting somatization symptoms.