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The British Journal of Psychiatry (2004) 184: 470-476
© 2004 The Royal College of Psychiatrists

Somatoform disorders in general practice

Prevalence, functional impairment and comorbidity with anxiety and depressive disorders{dagger}

Margot W. M. De Waal, MSc, Ingrid A. Arnold, MD and Just A. H. Eekhof, PhD

Department of General Practice and Nursing Home Medicine, Leiden University Medical Centre

Albert M. Van Hemert, PhD

Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands

Correspondence: M.W.M. de Waal, LUMC Department of General Practice and Nursing Home Medicine, PO Box 2088, 2301 CB Leiden, The Netherlands. Tel: +31 71 5275318; fax: +31 71 5275325; e-mail: M.W.M.de_Waal{at}lumc.nl

Declaration of interest None.

{dagger} See editorial, pp. 465–467, this issue.

Background General practitioners play a pivotal part in the recognition and treatment of psychiatric disorders. Identifying somatoform disorders is important for the choice of treatment.

Aims To quantify the prevalence of, and functional impairment associated with, somatoform disorders, and their comorbidity with anxiety/depressive disorders.

Method Two-stage prevalence study: a set of questionnaires was completed by 1046 consecutive patients of general practitioners (aged 25–80 years), followed by a standardised diagnostic interview (SCAN 2.1).

Results The prevalence of somatoform disorders was 16.1% (95% CI12.8–19.4). When disorders with only mild impairment were included, the prevalence increased to 21.9%. Comorbidity of somatoform disorders and anxiety/depressive disorders was 3.3 times more likely than expected by chance. In patients with comorbid disorders, physical symptoms, depressive symptoms and functional limitations were additive.

Conclusions Our findings underline the importance of a comprehensive diagnostic approach to psychiatric disorders in general practice.


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