Somatic Symptoms in Primary Care: Etiology and Outcome

Adnan A. Khan, Ayesha Khan, Jaroslaw Harezlak, Wanzhu Tu, Kurt Kroenke

Research output: Contribution to journalArticle

119 Scopus citations

Abstract

Although somatic complaints are the predominant reason for seeking general medical care, their etiology and prognosis remain poorly understood. In a random sample of the records of all patients visiting an urban primary care clinic during four 1-month periods, 289 patients had one or more somatic symptoms, a total of 433 symptoms. Using explicit criteria, physician raters classified nearly half (48%) of the symptoms as either psychiatric or idiopathic in etiology. Reviewing follow-up notes for 12 months after the index visit, raters found that at least one-fourth of the symptoms persisted. Independent predictors of symptom persistence were prior visits for the same symptom, symptom type (i.e., headache or back pain), male gender, and greater medical comorbidity (i.e., seven or more medical diagnoses). Developing better management strategies for prevalent, medically unexplained, persistent somatic symptoms is a health care priority.

Original languageEnglish (US)
Pages (from-to)471-478
Number of pages8
JournalPsychosomatics
Volume44
Issue number6
DOIs
StatePublished - Jan 1 2003

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health

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