Long-Term Outcome of Bodily Distress Syndrome in Primary Care

A Follow-Up Study on Health Care Costs, Work Disability, and Self-Rated Health

Bibliographic Data

ID19304474
AuthorsMette Trøllund Rask (0000-0002-0460-9484, Aarhus University, corresponding author), Eva Ørnbøl (0000-0002-5915-9839, Aarhus University Hospital), Marianne Rosendal (0000-0002-3257-9665, Aarhus University Hospital), Per Fink (0000-0003-2921-4099, Aarhus University Hospital)
Year2017
Volume79
Issue3
Pages345-357
Publication date2017-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000000405
PMID27768649
OpenAlexW2537238316
LanguageEN
Citations received6
References cited48

OBJECTIVE: The upcoming International Classification of Diseases, 11th Revision for primary care use suggests inclusion of a new diagnostic construct, bodily (di)stress syndrome (BDS), for individuals with medically unexplained symptoms. We aimed to explore the long-term outcome of BDS in health care costs, work disability, and self-rated health. METHODS: Consecutive patients consulting their family physician for a new health problem were screened for physical and mental symptoms by questionnaires (n = 1785). A stratified subsample was examined with a standardized diagnostic interview (n = 701). Patients with single-organ BDS (n = 124) and multiorgan BDS (n = 35), and a reference group with a family physician-verified medical condition (n = 880) were included. All included patients completed a questionnaire at 3, 12, and 24 months of follow-up. Register data on health care costs and work disability were obtained after 2 and 10 years of follow-up, respectively. RESULTS: Patients with BDS displayed poorer self-rated health and higher illness worry at index consultation and throughout follow-up than the reference group (p ≤ .001). The annual health care costs were higher in the BDS groups (2270 USD and 4066 USD) than in the reference group (1392 USD) (achieved significance level (ASL) ≤ 0.001). Both BDS groups had higher risk of sick leave during the first 2 years of follow-up (RRsingle-organ BDS = 3.0; 95% confidence interval [CI] = 1.8-5.0; RRmultiorgan BDS = 3.4; 95% CI = 1.5-7.5) and substantially higher risk of newly awarded disability pension than the reference group (HRsingle-organ BDS = 4.9; 95% CI = 2.8-8.4; HRmultiorgan BDS = 8.7; 95% CI = 3.7-20.7). CONCLUSIONS: Patients with BDS have poor long-term outcome of health care costs, work disability, and subjective suffering. These findings stress the need for adequate recognition and management of BDS

Anxiety · Confidence interval · Disability pension · Distress · Environmental health · Family medicine · Health care · Physical therapy · Population · Psychiatry · Sick leave · Worry · Clinical Psychology · Fibromyalgia and Chronic Fatigue Syndrome Research · Internal Medicine · Medicine · Obsessive-Compulsive Spectrum Disorders · Psychosomatic Disorders and Their Treatments · Gerontology · Pediatrics

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