Abstract
BackgroundMany primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors.MethodsA cross-sectional design was used to interview 400 attendees. Men and women aged over 18 years old without a psychiatric diagnosis were invited to participate. The Somatization scale of the Four-Dimensional Symptom Questionnaire was used to assess somatic symptom disorders. It is a valid tool to be used in a PHC setting. We used the Chi-square test and multivariable logistic regression to explore determinant variables.ResultsPrevalence of SSD was 32.5% (95%CI = 27.9–37.1%). The most common symptoms were painful muscles (61.5%) followed by back pain (52.3%). Female gender [adjusted OR = 2.1 (95% CI = 1.2–3.7)], chronic diseases [adjusted OR = 2.4 (95%CI = 1.3–4.5)], depression [adjusted OR = 3.3 (95%CI = 2.0–5.5)], and anxiety [adjusted OR = 2.1 (95%CI = 1.2–3.6)] were all associated with SSD. In addition, frequent primary health care attendance was found to be associated with SSD [adjusted OR = 2.4 (95%CI = 1.4–4.1)].ConclusionsSSD significantly higher among females, patients with chronic diseases, clients with anxiety and depressive disorders, and patients with frequent doctors’ visits. Painful muscles and back pain are the most common symptom presented by patients, and this could be used initially by PHC physicians as a signal to consider for screening.
Highlights
Somatization is the expression of psychological or emotional distress through physical symptoms that are otherwise unexplained
Physical symptoms may or may Nazzal et al BMC Health Services Research (2021) 21:615 not be associated with a particular medical condition, but people experience symptoms and feel ill [2]
We selected the sample through the use of convenient sampling methods, which included a serial recruitment of participants attending primary health care clinics in Nablus district, the second most populous district in the West Bank
Summary
Somatization is the expression of psychological or emotional distress through physical symptoms that are otherwise unexplained. It has been argued that it is so common in primary health care (PHC) as to be Nazzal et al BMC Health Services Research (2021) 21:615 not be associated with a particular medical condition, but people experience symptoms and feel ill [2]. The results of a regional Iranian study showed a high prevalence of somatic symptoms of varying severity. SSD was associated with female gender and low educational level among Kuwaiti PHC attendees [5]. Many primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors
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