Introduction: Symptom diagnoses are diagnoses used in primary care when the relevant diagnostic criteria of a disease are not fulfilled. Although symptom diagnoses often get resolved spontaneously without a clearly defined illness nor treatment, up to 38% of these symptoms persist more than 1 year. It is largely unknown how often symptom diagnoses occur, which symptoms persist, and how general practitioners (GPs) manage them.Aim: Explore morbidity rates, characteristics and management of patients with nonpersistent (≤1 year) and persistent (>1 year) symptom diagnoses.Methods: A retrospective cohort study was performed in a Dutch practice-based research network including 28,590 registered patients. We selected symptom diagnosis episodes with at least 1 contact in 2018. We performed descriptive statistics, Student's T and x 2 tests to summarize and compare patients' characteristics and GP management strategies in the nonpersistent and persistent groups.Results: The incidence rate of symptom diagnoses was 767 episodes per 1000 patient-years. The prevalence rate was 485 patients per 1000 patient-years. Out of the patients who had a contact with their GPs, 58% had at least 1 symptom diagnosis, from which 16% were persistent (>1 year). In the persistent group, we found significantly more females (64% vs 57%), older patients (mean: 49 vs 36 years of age), patients with more comorbidities (71% vs 49%), psychological (17% vs 12%) and social (8% vs 5%) problems. Prescriptions (62% vs 23%) and referral (62.7% vs 30.6%) rates were significantly higher in persistent symptom episodes.Conclusion: Symptom diagnoses are highly prevalent (58%) of which a considerable part (16%) persists more than a year. ( J Am Board Fam Med ;

No abstract

No abstract

Objective:To analyze the prevalence, the clinical, therapeutic and evolutional aspects of patients treated for catatonia with the intention to improve daily clinical care.Method: A retrospective study. Results:Between 2004 and 2013, 32 patients were clinically diagnosed as having catatonia, with a prevalence of 0.97% among hospitalized patients. The patients were predominantly under 40 years old (65%), women (62%), single (50%), jobless (56%), and of primary education level (65%). Most of the patients give a somatic (31%) and psychiatric history (59%). Psychiatric disorders were frequently associated such as schizophrenia (n=8), and mood disorders (n=4), anxiety disorder (n=2), catatonia (n=1) and other psychiatric disorders. Progressive onset (pseudo-neurotic, behavior disorder, activity declining or behavior's modification) was observed in 17 patients. Most clinical events were motor immobility, stupor and mutism. Of the 32 patients, two-thirds had partial response to treatment while complete remission was observed in 16% of cases. Early somatic complications were frequent (37.5%) and two patients died. Conclusions:A retrospective evaluation of 32 catatonic patients revealed a great variety of clinical events, and psychiatric disorders associated with catatonia, from which schizophrenia and mood disorders are the most frequent. Catatonia is a serious affection considered as an emergency, which remains under diagnosed. So, developing a clinical protocol to improve daily care may be very interesting and complex.