Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data

B. van der Berg, C.J. Yzermans, P.G. van der Velden, R. Stellato, E. Lebret, Linda Grievink

Research output: Contribution to journalArticleScientificpeer-review

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.
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalBMC Health Services Research
DOIs
Publication statusPublished - 2007

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Disasters
Self Report
General Practitioners
Survivors
Precipitating Factors
Health Surveys
Medically Unexplained Symptoms

Cite this

van der Berg, B. ; Yzermans, C.J. ; van der Velden, P.G. ; Stellato, R. ; Lebret, E. ; Grievink, Linda. / Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data. In: BMC Health Services Research. 2007 ; pp. 1-10.
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title = "Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data",
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.",
author = "{van der Berg}, B. and C.J. Yzermans and {van der Velden}, P.G. and R. Stellato and E. Lebret and Linda Grievink",
year = "2007",
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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. / van der Berg, B.; Yzermans, C.J.; van der Velden, P.G.; Stellato, R.; Lebret, E.; Grievink, Linda.

In: BMC Health Services Research, 2007, p. 1-10.

Research output: Contribution to journalArticleScientificpeer-review

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 der Berg, B.

AU - Yzermans, C.J.

AU - van der Velden, P.G.

AU - Stellato, R.

AU - Lebret, E.

AU - Grievink, Linda

PY - 2007

Y1 - 2007

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.

AB - 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.

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DO - 10.1186/1472-6963-7-150

M3 - Article

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JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

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