Studying ICD-11 Primary Health Care bodily stress syndrome in Brazil: do many functional disorders represent just one syndrome?

Abstract

Objective:Disorders characterized by “distressing unexplained somatic symptoms” are challenging. In the ICD-11 Primary Health Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (ICD-11 PHC), a new category, bodily stress syndrome (BSS), was included to diagnose patients presenting unexplained somatic symptoms. The present study investigated the association of BSS with anxiety, depression, and four subgroups of physical symptoms in a Brazilian primary health care (PHC) sample.Methodology:As part of the international ICD-11 PHC study, 338 patients were evaluated by their primary care physicians, followed by testing with Clinical Interview Schedule (CIS-R) and World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0). BSS was diagnosed in the presence of at least three somatic symptoms associated with incapacity. The association between anxiety, depression, and four subgroups of physical symptoms with being a BSS case was analyzed.Results:The number of somatic symptoms was high in the overall sample of 338 patients (mean = 8.4), but even higher in the 131 BSS patients (10.2; p < 0.001). Most BSS patients (57.3%) had at least three symptoms from two, three, or four subgroups, and these were associated with anxiety and depression in 80.9% of these patients. The symptom subgroup most strongly associated with “being a BSS” case was the non-specific group (OR = 6.51; 95%CI 1.65-24.34), followed by musculoskeletal (OR = 2,31; 95%CI 1.19-4.72).Conclusion:Somatic symptoms were frequent in a sample of PHC patients in Brazil. In the present sample, one third were BSS cases and met the criteria for at least two symptom subgroups, supporting the hypothesis that different functional symptoms are related to each other.

Mental health problems among healthcare workers involved with the COVID-19 outbreak

“…The frequencies of these MHPs in all the groups were much higher than national 33,34 and global averages, 35 even in conflict settings. 36 Additionally, in line with previous reports of a high frequency of physical symptoms as an expression of emotional distress in Latin-American countries, [15][16][17][18] a large proportion of Mexican frontline HCWs reported clinically significant symptoms of health anxiety/somatization.…”

“…Likewise, somatization and increased psychoactive substance use may be frequent MHPs in HCWs from Latin-American countries, where physical symptoms are known to be part of the cultural pattern of emotional distress [15][16][17][18] and high-risk alcohol consumption has been observed, mostly in men. 19 In order to strengthen Mexico's National Mental Health System by identifying the presence of MHPs and evaluating COVID-19 coping strategies among HCWs, the Ministry of Health, in collaboration with the Universidad Nacional Autónoma de México, developed a brief remote evaluation tool for use on its website during the epidemic.…”

Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

“…Only few studies have been made on BDS, and these constitute mainly studies on clinical samples. These studies also find cases of BDS being associated with the female sex 34,61,62 , unemployment [62][63][64] , poor health, limitations in daily functioning [62][63][64][65] , high comorbidity with physical disease and other FSS, and mental disorders 34,62,64,65 .…”

Análise Epidemiológica E O Rastreio De Vacinação De Sarampo No Brasil Durante a Pandemia Do Novo Coronavírus (Sars-Cov-2) No Ano De 2020

“…Em relação a sintomas somáticos, foi possível identificar principalmente a referência a dores de cabeça frequentes. Esse tipo de sintomatologia frequentemente não consegue ser justificável por uma patologia orgânica e constantemente é associada com sofrimento psíquico (FORTES et al, 2019). Os aspectos desta dimensão frequentemente podem estar associados, de forma causal, a dimensão decréscimo de energia vital, que neste estudo identificou a dificuldade para dormir como um achado, principalmente na população adulta.…”