Physical Illnesses and Psychological Characteristics of Outpatients with Multiple Somatic Symptoms in a General Hospital

  Objective  To explore the physical diseases and psychological characteristics of patients with multiple somatic symptoms in the outpatient departments in a general hospital.

  Methods  This cross-sectional study was conducted from March to October, 2012. The participants were recruited through convenience sampling from the outpatient departments of Gastroenterology, Traditional Chinese Medicine, and Psychological Medicine in Peking Union Medical College Hospital. Patients in the waiting list were screened continuously by the somatic symptom scale of the Patient Health Questionnaire (PHQ-15). With the cut-off value of 10, patients were divided into the somatic symptom positive (SOM+) group and the control (SOM-) group. With 25patients enrolled for eachgroup from all these three departments, totally 150 patients were included. All the subjects completed seven self-assessment questionnaires including PHD-15, depression scale of the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), 12-item Short Form Health Survey (SF-12), Whiteley-7 Index (WI-7), Sense of Coherence scale(SOC-9), and health care used and health status scales, and received semi-structured interviews including the diagnosed physical and psychological illnesses during the past 12 months and the Mini-International Neuropsychiatric Interview (MINI).

  Results  The proportions of females and subjects with an education degree below college were significantly higher in SOM+ group than in SOM-group (69.3% vs 53.3%, 54.8% vs 43.2%, respectively; both P < 0.05). While no more physical illness was diagnosed in the past 12 months in the SOM+ group. The prevalence of depression, generalized anxiety disorder, and hypochondriasis and the scores of PHQ-9 and WI-7 were significantly higher in the SOM+ group (P < 0.05). The behavior and daily activities of SOM+ group patients were also more likely to be influenced by their discomforts (P < 0.01). Finally, Logistic regression analysis showed that the high scores of PHQ-9 and WI-7 and unemployment were the influential factors of these manifestations.

  Conclusions  Patients with multiple somatic symptoms do not have more physical illnesses that can be clearly diagnosed. However, they have more psychological distress and lower quality of life, and are more likely to be affected by the symptoms. The high degree of depression and anxiety and unemployment were the influential factors for multiple somatic symptoms.