The relationship of somatization with fatigue and exhaustion as chief complaints

Abstract

Background Text Somatization is the expression of mental distress and psychosocial stress with physical symptoms. Medically Unexplained Symptoms (MUS) are defined as symptoms like fatigue, exhaustion and general body pain that causes patients to apply to a doctor repeatedly, without the presence of an underlying organic disease, and lasts more than three months. Its' frequency in primary care is 20-30 per cent. Aims The aim of this study is to determine the underlying psychiatric comorbidity in patients that apply to Family Medicine clinic with the mentioned complaints using the PHQ-SADS scale. Methods From the patients that applied to Marmara University Pendik Research and Teaching Hospital Family Medicine clinic with complaints of fatigue and exhaustion between January 2019 and May 2019, those that were between 1865 years of age and did not have any diagnosed, chronic psychiatric disease, cancer, uncontrolled diabetes, hypothyroidism, and rheumatological diseases were included in the study. A questionnaire including demographic characteristics and the PHQ-SADS scale was applied to the participants. Results The number of participants was 65, the mean age was 36 +/- 10.5 years, 84.6 per cent were women, and the level of education was mainly high school and higher. The presence of chronic disease increased with age. The most frequent chief complaint was fatigue and the most ordered test was a complete blood count (92.2 per cent). The most common diagnosis was iron and vitamin D deficiency together (n=22).The most frequent score level of the applied PHQ-SADS scale was moderate-severe (66.2 per cent) in the subscale PHQ-15 which screens somatization symptoms. Patients with chronic diseases had higher PHQ-15 and PHQ-9 scores (p=0.025 and p=0.22 respectively). Conclusion Patients' visiting primary care physicians with recurrent and undifferentiated complaints is a frequently encountered situation. Somatization levels are found to be high in these patients. Physicians recognizing and managing this situation appropriately may help to reduce these multiple doctor visits.