[Somatoform disorders in general practice: prevalence, functional limitations and comorbidity with anxiety and depression]. / Somatoforme stoornissen in de huisartspraktijk: prevalentie, functionele beperkingen en comorbiditeit met angst en depressie.

OBJECTIVE: To quantify the prevalence of, and functional impairment associated with, somatoform disorders in general practice and their comorbidity with anxiety and depression. DESIGN: Prevalence study. METHOD: In the first phase of a two-stage prevalence study from April 2000 up to December 2001, a questionnaire was completed by 1046 consecutive attendees at general practices, aged 25-79 years (n = 1778). This was followed in the second phase by a standardised diagnostic interview ('Schedules for clinical assessment in neuropsychiatry'; SCAN 2.1) in a stratified sample of 473 patients. In the analyses, the prevalence figures were estimated by weighting back to the original attending population. RESULTS: The prevalence ofsomatoform disorders was 16% (95% CI: 12.8-19.4). Comorbidity of somatoform disorders and anxiety or depression disorders was 3.3 times more likely than would be expected by chance. Somatoform disorders as well as anxiety or depressive disorders were associated with substantial functional impairment. In patients with comorbid disorders, physical symptoms, depressive symptoms and functional limitations were proportionately increased. CONCLUSION: These findings underline the importance of a comprehensive diagnostic approach covering anxiety and depressive disorders as well as somatoform disorders in general practice.

Medically unexplained physical symptoms: the feasibility of group cognitive-behavioural therapy in primary care.

OBJECTIVE: The aim of this study was to estimate the number of patients with medically unexplained physical symptoms (MUPS) that could be eligible for group cognitive-behavioural treatment (CBT) and to assess the acceptability of this treatment. METHODS: For 3 months, all consultations of one general practitioner (GP) were screened for MUPS. Patients with MUPS who were considered eligible for group CBT were interviewed and offered treatment. RESULTS: From January to March 1999, 1084 consultations of 796 patients were screened. The GP classified the symptoms of 104 patients aged 25-79 as unexplained. Of these, 71 patients were not considered to be eligible for treatment, mainly due to a psychological attribution of the symptoms. The research interview was offered to 33 patients, 16 of them declined and 12 were interviewed. Seven out of the 12 eligible patients accepted treatment. CONCLUSION: In primary care, 18% of patients aged 25-79 years was estimated to have MUPS. For only a minority of these patients, group CBT was considered suitable and acceptable.