Non-specific symptoms as clues to changes in emotional well-being

Abstract

Background -Somatic symptoms are a common reason for visits to the family physician. The aim of this study was to examine the relation between non-specific symptoms and changes in emotional well-being and the degree to which the physician considers the possibility of mental distress when faced with such patients.Methods -Patients who complained of two or more symptoms including headache, dizziness, fatigue or weakness, palpitations and sleep disorders over one year were identified from the medical records of a random sample of 45 primary care physicians. A control group matched for gender and age was selected from the same population. Emotional well-being was assessed using the MOS-SF 36 in both groups.Results -The study group and the control group each contained 110 patients. Completed MOS questionnaires were obtained from 92 patients, 48 patients with somatic symptoms and 44 controls. Sixty percent of the patients with somatic symptoms experienced decreased emotional well being compared to 25% in the control group (p = 0.00005). Symptoms of dizziness, fatigue and sleep disturbances were significantly linked with mental health impairments. Primary care physicians identified only 6 of 29 patients (21%) whose responses revealed functional limitations due to emotional problems as suffering from an emotional disorder and only 6 of 23 patients (26%) with a lack of emotional well being were diagnosed with an emotional disorder.Conclusions -Non-specific somatic symptoms may be clues to changes in emotional well-being. Improved recognition and recording of mental distress among patients who complain of these symptoms may enable better follow up and treatment.

Patient reported outcome measures (PROMs) in primary care: an observational pilot study of seven generic instruments

“…The questionnaire also included questions about non-specific symptoms and the number of GP contacts in the previous 12 months. Non-specific symptoms included fatigue, dizziness, headache, weakness, palpitation and sleep problems, and their presence can indicate underlying changes in emotional well-being [ 20 ]. As said, some instruments that aimed to measure the same domain were used alternately to reduce length.…”

Chinese perspectives on primary care for common mental disorders: Barriers and policy implications

“…It is well known that many patients present with psychosomatic symptoms only (Cape & McCulloch, 1999;A. Tylee, Freeling, Kerry, & Burns, 1995), such as headache, dizziness, fatigue/weakness, palpitations and sleep problems (Matalon, Kotliroff, Blumberg, Yaphe, & Kitai, 2011). Patients may not link their symptoms to psychological causes (Murray, Toussaint, Althaus, & Lowe, 2016).…”

“…Besides, somatization is considered as a way for some patients to avoid expression of mental health problems which are subject to social stigma (Murray, et al, 2016;Simon, VonKorff, Piccinelli, Fullerton, & Ormel, 1999). Some patients may be treated as having functional, non-specific, or medically unexplained symptoms without a formal diagnosis of mental disorder (Matalon, et al, 2011). Unnecessary somatic treatments may be prescribed (Walters, Tylee, Fisher, & Goldberg, 2007).…”

Emergency Presentations With Nonspecific Complaints—the Burden of Morbidity and the Spectrum of Underlying Disease

“…This finding is consistent with previous reports of higher hospitalization rates for acute morbidity in men in Switzerland, for example, pneumonia or heart failure. 17 , 23 , 33 Nevertheless, an inclusion bias cannot be completely excluded, as the hospitalization of elderly women may occur with different triggers, possibly due to their role as caregivers or 3-fold higher chance of being widowed.…”