Epidemiology and prevalence of somatic symptom disorder at the primary care level in Muscat, Oman: A cross-sectional study

Abstract

Objectives Somatic symptom disorder (SSD) is a diagnostic classification to describe the occurrence of physical symptoms without organic cause. This study aimed to identify prevalence rates and associated characteristics of SSD among adults in primary care settings. Methods This cross-sectional study took place between July 2020 and March 2021 and included a random selection of 3383 Omani adults attending 12 primary healthcare centres in Muscat Governorate. Screening was conducted using an Arabic version of the Somatic Symptom Scale-8 (SSS-8). Results A total of 2000 adults participated in the study (response rate: 67.3%), of which most were female (71.7%) and under 50 years old (86.2%). Based on their SSS-8 scores, 602 participants (17.8%) had SSD, resulting in an overall prevalence estimate of 30.1% (95% confidence interval: 28.13–32.15). Significant associations were observed between SSD and age ( p = 0.002), gender ( p < 0.001), marital status ( p = 0.030) and chronic comorbidities ( p = 0.001). In addition, adjusted odds ratio estimates revealed SSD to be significantly associated with gender ( p < 0.001), education level ( p < 0.001) and chronic comorbidities ( p = 0.001). Conclusion The estimated prevalence of SSD in primary care settings is high compared to reports from elsewhere in the Gulf region. There is an urgent need to enhance the diagnosis of SSD at the primary care level in order to reduce healthcare service overutilisation and patient dissatisfaction. Moreover, healthcare practitioners should be aware of the effect of age, gender, educational status and chronic comorbidities on somatic symptoms.

Scoping review update on somatic symptom disorder that includes additional Chinese data

“…One of these studies was conducted in the general population, 40 and two were carried out on primary care patients. 41 42 Significantly, prevalence studies on the general population using diagnostic criterion standard interviews are lacking, though needed. A cross-sectional nationally representative population survey performed in Germany (2020) reported prevalence data using SSS-8 as the diagnostic tool; they found that 4.5% of the participants (n=2531) met the criteria of SSD.…”

“… 40 In primary care population studies, the frequency of proxy diagnosis for SSD has varied between 17.8% and 32.5% (mean frequency 25.15%). 41 42 In a study conducted in non-specialised general medicine settings, the prevalence of SSD was 27.1%. 36 In diverse specialised care settings (eg, endocrinology, cardiology, obstetrics and gynaecology, oncology and rheumatology), SSD frequency ranged between 21.6% and 45.3% (mean frequency of 33.45%).…”