The association of generalized anxiety disorder and Somatic Symptoms with frequent attendance to health care services

Abstract

Objective Generalized anxiety disorder is associated with higher rate of physical comorbities, unexplained symptoms, and health care utilization. However, the role of somatic symptoms in determining health care utilization is unclear. The present study aims to assess the association of frequent attendance of health care services between generalized anxiety disorder symptoms and somatic symptoms. Method This study was conducted cross-sectionally using the material of the 46-year follow-up survey of the Northern Finland Birth Cohort 1966. Altogether, 5585 cohort members responded to the questionnaires concerning health care utilization, illness history, physical symptoms, and generalized anxiety disorder-7 screening tool. Odds ratios belonging to the highest decile in health care utilization were calculated for generalized anxiety disorder symptoms and all (n = 4) somatic symptoms of Hopkins Symptom Checklist-25 controlled for confounding factors. Results Adjusted Odds ratios for being frequent attender of health care services were 2.29 (95% CI 1.58-3.31) for generalized anxiety disorder symptoms and 1.28 (95% CI 0.99-1.64), 1.94 (95% CI 1.46-2.58), 2.33 (95% CI 1.65-3.28), and 3.64 (95% CI 2.15-6.18) for 1, 2, 3, and 4 somatic symptoms, respectively. People with generalized anxiety disorder symptoms had on average a higher number of somatic symptoms (1.8) than other cohort members (0.9). Moreover, 1.6% of people without somatic symptoms tested positive for generalized anxiety disorder, meanwhile 22.6% of people with four somatic symptoms tested positive for generalized anxiety disorder. Conclusions Both generalized anxiety disorder symptoms and somatic symptoms are associated with a higher risk for being a health care frequent attender.

Comparison of Axis II psychosocial assessment methods of RDC/TMD and DC/TMD as part of DC/TMD‐FIN phase II validation studies in tertiary care Finnish TMD pain patients

“…33 In addition, Simoen et al 33 reported higher levels of anxiety symptoms among consecutive TMD pain patients compared to the general population in Belgium. In Finland, the corresponding prevalence in high health care utilisers in the Northern Finland Birth Cohort 1966 was shown to be lower, 46 and GAD-7 was shown to be valid and useful tool for screening for anxiety disorders in primary health care.…”

Cohort Profile: 46 years of follow-up of the Northern Finland Birth Cohort 1966 (NFBC1966)

“… 24 A recent study showed generalized anxiety disorder and somatic symptoms associating with frequent health care use. 25 …”

When worry is excessive: Easing the burden of GAD

“…2 Despite comorbidities, it is the somatic complaints in GAD that often drive patient requests for medical care. 7,8 GAD itself is an independent predictor of heart disease 9 and is linked to increased risk of chronic or severe headaches 10 and suicide. 11,12 Work with patients and family toward a diagnosis Despite the potential benefits of early identification and treatment of GAD, 13 the average elapsed time from symptom onset to initial medication treatment is 7 years.…”