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Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data.
BMC Health Serv Res 2007; 7:150BH

Abstract

BACKGROUND

Most studies examining medically unexplained symptoms (MUS) have been performed in primary or secondary care and have examined symptoms for which patients sought medical attention. Disasters are often described as precipitating factors for MUS. However, health consequences of disasters are typically measured by means of questionnaires, and it is not known whether these self-reported physical symptoms are presented to the GP. It is also not known if the self-reported symptoms are related to a medical disorder or if they remain medically unexplained. In the present study, three research questions were addressed. Firstly, were self-reported symptoms among survivors presented to the GP? Secondly, were the symptoms presented to the GP associated with a high level of functional impairment and distress? Thirdly, what was the GP's clinical judgment of the presented symptoms, i.e. were the symptoms related to a medical diagnosis or could they be labeled MUS?

METHODS

Survivors of a man-made disaster (N = 887) completed a questionnaire 3 weeks (T1) and 18 months (T2) post-disaster. This longitudinal health survey was combined with an ongoing surveillance program of health problems registered by GPs.

RESULTS

The majority of self-reported symptoms was not presented to the GP and survivors were most likely to present persistent symptoms to the GP. For example, survivors with stomachache at both T1 and T2 were more likely to report stomachache to their GP (28%) than survivors with stomachache at only T1 (6%) or only T2 (13%). Presentation of individual symptoms to the GP was not consistently associated with functional impairment and distress. 56 - 91% of symptoms were labeled as MUS after clinical examination.

CONCLUSION

These results indicate that the majority of self-reported symptoms among survivors of a disaster are not presented to the GP and that the decision to consult with a GP for an individual symptom is not dependent on the level of impairment and distress. Also, self-reported physical symptoms such as headache, back pain and shortness of breath are likely to remain medically unexplained after the clinical judgment of a GP.

Authors+Show Affiliations

National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. bellis.van.den.berg@regioplan.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17888144

Citation

van den Berg, Bellis, et al. "Are Physical Symptoms Among Survivors of a Disaster Presented to the General Practitioner? a Comparison Between Self-reports and GP Data." BMC Health Services Research, vol. 7, 2007, p. 150.
van den Berg B, Yzermans CJ, van der Velden PG, et al. Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data. BMC Health Serv Res. 2007;7:150.
van den Berg, B., Yzermans, C. J., van der Velden, P. G., Stellato, R. K., Lebret, E., & Grievink, L. (2007). Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data. BMC Health Services Research, 7, p. 150.
van den Berg B, et al. Are Physical Symptoms Among Survivors of a Disaster Presented to the General Practitioner? a Comparison Between Self-reports and GP Data. BMC Health Serv Res. 2007 Sep 21;7:150. PubMed PMID: 17888144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data. AU - van den Berg,Bellis, AU - Yzermans,C Joris, AU - van der Velden,Peter G, AU - Stellato,Rebecca K, AU - Lebret,Erik, AU - Grievink,Linda, Y1 - 2007/09/21/ PY - 2006/10/16/received PY - 2007/09/21/accepted PY - 2007/9/25/pubmed PY - 2007/12/29/medline PY - 2007/9/25/entrez SP - 150 EP - 150 JF - BMC health services research JO - BMC Health Serv Res VL - 7 N2 - BACKGROUND: Most studies examining medically unexplained symptoms (MUS) have been performed in primary or secondary care and have examined symptoms for which patients sought medical attention. Disasters are often described as precipitating factors for MUS. However, health consequences of disasters are typically measured by means of questionnaires, and it is not known whether these self-reported physical symptoms are presented to the GP. It is also not known if the self-reported symptoms are related to a medical disorder or if they remain medically unexplained. In the present study, three research questions were addressed. Firstly, were self-reported symptoms among survivors presented to the GP? Secondly, were the symptoms presented to the GP associated with a high level of functional impairment and distress? Thirdly, what was the GP's clinical judgment of the presented symptoms, i.e. were the symptoms related to a medical diagnosis or could they be labeled MUS? METHODS: Survivors of a man-made disaster (N = 887) completed a questionnaire 3 weeks (T1) and 18 months (T2) post-disaster. This longitudinal health survey was combined with an ongoing surveillance program of health problems registered by GPs. RESULTS: The majority of self-reported symptoms was not presented to the GP and survivors were most likely to present persistent symptoms to the GP. For example, survivors with stomachache at both T1 and T2 were more likely to report stomachache to their GP (28%) than survivors with stomachache at only T1 (6%) or only T2 (13%). Presentation of individual symptoms to the GP was not consistently associated with functional impairment and distress. 56 - 91% of symptoms were labeled as MUS after clinical examination. CONCLUSION: These results indicate that the majority of self-reported symptoms among survivors of a disaster are not presented to the GP and that the decision to consult with a GP for an individual symptom is not dependent on the level of impairment and distress. Also, self-reported physical symptoms such as headache, back pain and shortness of breath are likely to remain medically unexplained after the clinical judgment of a GP. SN - 1472-6963 UR - https://www.unboundmedicine.com/medline/citation/17888144/Are_physical_symptoms_among_survivors_of_a_disaster_presented_to_the_general_practitioner_A_comparison_between_self_reports_and_GP_data_ L2 - https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-7-150 DB - PRIME DP - Unbound Medicine ER -