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Unexplained Symptoms in Primary Care: Predicting Anxiety and Depression

This presentation investigates the prevalence of unexplained symptoms in primary care and their potential link to depression and anxiety. We explore research questions regarding the percentage of general practitioner diagnoses attributed to these symptoms and how frequently patients present with them. Utilizing data from the Transition Project, which involved 16,000 patients and their encounters over 11 years, we analyze associations between somatic symptoms and mental health issues. The findings aim to enhance understanding of mental health implications in primary care settings.

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Unexplained Symptoms in Primary Care: Predicting Anxiety and Depression

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  1. Amsterdam April 2011 Do unexplained symptoms predict anxiety or depressionin primary care. Kees van Boven Peter Lucassen, Tim OldeHartman Hiskevan Ravesteijn Sibo Oskam Hans Bor Evelyn van Weel-Baumgarten Chris van Weel.

  2. Presentation Contents Quizz Research questions Transition project Physical symptoms Mental health problems Conclusion and Discussion

  3. Symptoms are sometimes the manifestation of a disease; frequently symptoms are not explained by disease. In the latter case, the general practitioner makes a ‘symptom diagnosis’.What percentage of all diagnoses of a general practitioner per year is a ‘symptom diagnosis’? O 0–10% O 10-20% O 20-30% O 30-50%

  4. Part of the patients in primary care very frequently present unexplained symptoms i.e. symptoms not explained by disease. • What percentage of all patients in primary care do very frequently present unexplained symptoms? • O 0-2% • O 2-4% • O 4-6% • O 6-8%

  5. In how many patients with unexplained symptoms is depression or anxiety the causes of the symptoms? O 0-5% O 5-10% O 10-15% O 15-20%

  6. Research questions • Are mental health problems associated with unexplained symptoms presented to the GP? • Do unexplained symptoms, presented to the GP, predict a mental health problem?

  7. TransitionProject 16 000 patients ICPC classification Data Patients followed for 1-11 years (1997 – 2008) 419056 encounters with patients >=15 year ICPC codes Reason for encounter Diagnosis Intervention Structured in an Episode of care

  8. OddsRatios • Cross-sectional analysis of data with a time frame of one year. Association of somatoform and somatic symptoms with anxiety and depressive disorder (ORs, 95%Ci)

  9. Cross-sectional analysis of data with a time frame of one year. Association of somatic symptoms with anxiety and depressive disorder (ORs, 95%Ci) OddsRatios

  10. Cross-sectional analysis in a time frame of one year (2007). Percentages of patients with/without anxiety or depression in patients presenting with different numbers of symptom episodes.

  11. This seems usefull, but…

  12. OddsRatios • Cross-sectional analysis of data with a time frame of one year. • Association of somatic symptoms with anxiety and depressive disorder (ORs, 95% CIs)

  13. OddsRatios • Cross-sectional analysis of data with a time frame of one year. • Association of somatic symptoms with anxiety and depressive disorder (ORs, 95% CIs)

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