TY - JOUR
KW - Activities of Daily Living/psychology
KW - Anxiety Disorders/diagnosis/epidemiology/psychology
KW - Cohort Studies
KW - Comorbidity
KW - Cross-Sectional Studies
KW - Depressive Disorder/diagnosis/epidemiology/psychology
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Panic Disorder/diagnosis/epidemiology/psychology
KW - Patient Satisfaction/statistics & numerical data
KW - Personality Inventory/statistics & numerical data
KW - Primary Health Care/utilization
KW - Prognosis
KW - Psychometrics
KW - Sick Role
KW - Somatoform Disorders/diagnosis/epidemiology/psychology
KW - Utilization Review
AU - J. L. Jackson
AU - K. Kroenke
A1 - 
AB - BACKGROUND: To determine the prevalence, impact, and prognosis of multisomatoform disorder (MSD) over a 5-year period in a primary care population. Although somatization is prevalent in primary care, patients rarely meet Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for somatization disorder. MSD, defined as > or = 3 bothersome, medically unexplained somatic symptoms, has been proposed as a more inclusive disorder. METHODS: A total of 500 adults presenting to a primary care clinic with a physical symptom were screened with the Primary Care Evaluation of Mental Disorders. Symptom count was assessed with the Patient Health Questionnaire 15-item somatic symptom scale. Additional baseline measures included functional status and symptom characteristics. Follow-up surveys at 2 weeks, 3 months, and 5 years assessed functioning, symptom outcome, psychiatric diagnoses, and patient satisfaction. Physician surveys assessed encounter difficulty. Utilization was obtained from our health database. RESULTS: MSD had an 8% prevalence at both baseline (n = 38/500) and at 5 years (n = 33/387). MSD persisted in 21% of those with MSD at baseline, and developed in 7% of those without MSD at baseline. MSD at baseline was a predictor of MSD at 5 years (relative risk (RR) = 2.7, 1.5-5.1). MSD patients were more likely to have comorbid mental disorders (RR = 1.5, 1.1-2.3) and be rated "difficult" by their clinicians (p = .02). They also reported worse functional status at all time points assessed (p < .001 for all), were less likely to experience symptom improvement, and had higher utilization rates (34.1 versus 23.1 visits; p = .006). CONCLUSIONS: MSD identifies a group of patients who are less likely to experience symptom improvement and have significant functional impairment and higher utilization rates.
BT - Psychosomatic medicine
C5 - Medically Unexplained Symptoms
CP - 4
CY - United States
DO - 10.1097/PSY.0b013e31816aa0ee
IS - 4
JF - Psychosomatic medicine
N2 - BACKGROUND: To determine the prevalence, impact, and prognosis of multisomatoform disorder (MSD) over a 5-year period in a primary care population. Although somatization is prevalent in primary care, patients rarely meet Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for somatization disorder. MSD, defined as > or = 3 bothersome, medically unexplained somatic symptoms, has been proposed as a more inclusive disorder. METHODS: A total of 500 adults presenting to a primary care clinic with a physical symptom were screened with the Primary Care Evaluation of Mental Disorders. Symptom count was assessed with the Patient Health Questionnaire 15-item somatic symptom scale. Additional baseline measures included functional status and symptom characteristics. Follow-up surveys at 2 weeks, 3 months, and 5 years assessed functioning, symptom outcome, psychiatric diagnoses, and patient satisfaction. Physician surveys assessed encounter difficulty. Utilization was obtained from our health database. RESULTS: MSD had an 8% prevalence at both baseline (n = 38/500) and at 5 years (n = 33/387). MSD persisted in 21% of those with MSD at baseline, and developed in 7% of those without MSD at baseline. MSD at baseline was a predictor of MSD at 5 years (relative risk (RR) = 2.7, 1.5-5.1). MSD patients were more likely to have comorbid mental disorders (RR = 1.5, 1.1-2.3) and be rated "difficult" by their clinicians (p = .02). They also reported worse functional status at all time points assessed (p < .001 for all), were less likely to experience symptom improvement, and had higher utilization rates (34.1 versus 23.1 visits; p = .006). CONCLUSIONS: MSD identifies a group of patients who are less likely to experience symptom improvement and have significant functional impairment and higher utilization rates.
PP - United States
PY - 2008
SN - 1534-7796; 0033-3174
SP - 430
EP - 434
EP - 
T1 - Prevalence, impact, and prognosis of multisomatoform disorder in primary care: a 5-year follow-up study
T2 - Psychosomatic medicine
TI - Prevalence, impact, and prognosis of multisomatoform disorder in primary care: a 5-year follow-up study
U1 - Medically Unexplained Symptoms
U2 - 18434494
U3 - 10.1097/PSY.0b013e31816aa0ee
VL - 70
VO - 1534-7796; 0033-3174
Y1 - 2008
ER -