Abstract
Background: A number of patients that attend primary care medical settings present with distressing bodily complaints which are not attributable to organic (physical) pathology. The difficulties in diagnosing and treating such patients have been observed by many Health Care Practitioners. This study assesses the presence of psychological conditions and attempts to make psychiatric diagnoses (using a standardized diagnostic instrument) in patients presenting with Functional Somatic Symptoms (FSS) in a primary care clinic at the University of Calabar Teaching Hospital. Method: The study was carried out at the General Out Patients Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH). It was a cross-sectional study of a convenience sample of 100 randomly selected patients presenting with Functional Somatic Symptoms. Those who consented filled the modified version of the Enugu Somatization Scale and were interviewed with the Schedule for Clinical Assessments in Neuropsychiatry (SCAN) for possible psychiatric diagnoses. Results: While 41 of the selected patients were males, 59 were females. Their mean age was 38.5 (SD = 12.2). Frequent headaches and body heat (internal heat) were the most prevalent symptoms in the patients. ICD-10 psychiatry diagnoses using the SCAN were made in 79% of the patients studied. Depressive disorders (diagnosed in 48% of the patients) and anxiety disorders (in 21%) were the most common diagnoses. Older patients were mainly diagnosed of depressive disorders (p = 0.016) whereas younger patients tended to receive diagnoses of anxiety disorders (p = 0.039). Conclusion: Patients presenting with FSS may have diagnosable psychiatric disorders which if not recognized would go untreated. Psychiatric referral may therefore reduce the sufferings of the patients.
Highlights
A significant number of patients seen in primary care clinics complain of physical symptoms which are not attributable to any known conventionally defined physical disorder
These are sometimes said to be medically unexplained or Functional Somatic Symptoms (Fink, Rosendale, & Olesen, 2005). These Functional Somatic Symptoms (FSS) have generated so much interest among psychiatrists working among Africans in Africa or in the Diaspora. Some of these symptoms such as the sensation of internal heat, peppery feeling and crawling sensations are so common amongst depressed Africans that some authors have gone on to state that depressed Africans do not manifest the traditional symptoms of depression (Ihezue, 1986)
It is yet to be understood whether somatization is a psychiatric disorder as presently conceptualized under somatoform disorder in the current classification system or whether the condition is a manifestation of anxiety, depression or other psychiatric disorders
Summary
A significant number of patients seen in primary care clinics complain of physical symptoms which are not attributable to any known conventionally defined physical disorder These are sometimes said to be medically unexplained or Functional Somatic Symptoms (Fink, Rosendale, & Olesen, 2005). This study assesses the presence of psychological conditions and attempts to make psychiatric diagnoses (using a standardized diagnostic instrument) in patients presenting with Functional Somatic Symptoms (FSS) in a primary care clinic at the University of Calabar Teaching Hospital. Method: The study was carried out at the General Out Patients Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH) It was a cross-sectional study of a convenience sample of 100 randomly selected patients presenting with Functional Somatic Symptoms.
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