Using the Patient Health Questionnaire to estimate prevalence and gender differences of somatic symptoms and psychological co-morbidity in a secondary inpatient population with abdominal pain

Aust N Z J Psychiatry. 2022 Aug;56(8):994-1005. doi: 10.1177/00048674211044639. Epub 2021 Sep 4.

Abstract

Background: Somatic disorders and somatic symptoms are common in primary care populations; however, little is known about the prevalence in surgical populations. Identification of inpatients with high somatic symptom burden and psychological co-morbidity could improve access to effective psychological therapies.

Methods: Cross-sectional analysis (n = 465) from a prospective longitudinal cohort study of consecutive adult admissions with non-traumatic abdominal pain, at a tertiary hospital in New South Wales, Australia. We estimated somatic symptom prevalence with the Patient Health Questionnaire-15 at three cut-points: moderate (⩾10), severe (⩾15) and 'bothered a lot' on ⩾3 symptoms; and psychological co-morbidity with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 at standard (⩾10) cut-points. We also examined gender differences for somatic symptoms and psychological co-morbidity.

Results: Prevalence was moderate (52%), female predominance (odds ratio = 1.71; 95% confidence interval = [1.18, 2.48]), severe (20%), no gender difference (1.32; [0.83, 2.10]) and 'bothered a lot' on ⩾3 symptoms (53%), female predominance (2.07; [1.42, 3.03]). Co-morbidity of depressive, anxiety and somatic symptoms ranged from 8.2% to 15.9% with no gender differences.

Conclusion: Somatic symptoms were common and psychological triple co-morbidity occurred in one-sixth of a clinical population admitted for abdominal pain. Co-ordinated surgical and psychological clinical intervention and changes in clinical service organisation may be warranted to provide optimal care.

Keywords: Patient Health Questionnaire-15; Somatic symptoms; abdominal pain; prevalence; surgical.

MeSH terms

  • Abdominal Pain / epidemiology
  • Adult
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inpatients
  • Longitudinal Studies
  • Male
  • Medically Unexplained Symptoms*
  • Patient Health Questionnaire
  • Prevalence
  • Prospective Studies