Symptoms in the community. Prevalence, classification, and psychiatric comorbidity.
Symptoms in the community. Prevalence, classification, and psychiatric comorbidity.
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DOI：
10.1001/archinte.1993.00410210102011
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发表时间：
1993-11
影响因子：
--
通讯作者：
K. Kroenke;R. K. Price
中科院分区：
文献类型：
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作者：
K. Kroenke;R. K. Price
虽然身体症状是门诊就诊的主要原因，但很大一部分身体不适和“轻微”疾病仍然知之甚少。我们研究的目的是确定一般人群中症状的患病率、患者归因原因和精神病合并症。方法：我们分析了流行病学集水区项目中采访的13，538名个体的数据，这是一项多社区精神健康调查，使用诊断访谈计划来确定精神疾病的患病率。诊断访谈计划询问了38种身体症状，并包括一个探测方案，以分类症状的严重程度和潜在的原因。我们关注了与初级保健最密切相关的26种症状。结果：在26种症状中，24种在10%以上的人的生活中出现过，最常见的非月经症状是关节痛头痛（24.9%）、胸痛（24.6%）、手臂或腿部疼痛（24.3%）、腹痛（23.6%）、疲劳（23.6%）和头晕（23.2%）。大多数症状（84%）在某些时候被认为是主要的，因为它们干扰了日常活动或导致个人服用药物或就医。近三分之一的症状是精神疾病或无法解释的，大多数症状与普通精神疾病的终身风险至少增加两倍有关。结论社区人群中的症状普遍存在，且令人困扰。通常缺乏明显的物理解释，这些症状与精神疾病的可能性增加有关。
BACKGROUND While physical symptoms are the leading reason for outpatient visits, a substantial proportion of physical complaints and "minor" illnesses remain poorly understood. The purpose of our study was to determine the prevalence, patient-attributed cause, and psychiatric comorbidity of symptoms in a general population. METHODS We analyzed data on 13,538 individuals interviewed in the Epidemiologic Catchment Area Program, a multicommunity mental health survey that used the Diagnostic Interview Schedule to determine the prevalence of psychiatric disorders. The Diagnostic Interview Schedule inquires about 38 physical symptoms and includes a probing scheme to classify symptom severity and potential cause. We focused on 26 symptoms most germane to primary care. RESULTS Of the 26 symptoms, 24 had been problems for more than 10% of persons at some point in their life, with the most common nonmenstrual symptoms being joint pains (36.7%), back pain (31.5%), headaches (24.9%), chest pain (24.6%), arm or leg pain (24.3%), abdominal pain (23.6%), fatigue (23.6%), and dizziness (23.2%). Most symptoms (84%) were at some point considered major in that they interfered with routine activities or had led individuals to take medications or visit a physician. Nearly one third of symptoms were either psychiatric or unexplained, and most symptoms were associated with at least a twofold increased lifetime risk of a common psychiatric disorder. CONCLUSION Symptoms in the community are prevalent as well as bothersome. Often lacking an apparent physical explanation, such symptoms are associated with an increased likelihood of psychiatric disorders.