CLINICAL FACTORS ASSOCIATED WITH SHORT-TERM CHANGES IN OUTCOME OF PATIENTS WITH SOMATIZED MENTAL DISORDER IN PRIMARY-CARE

Background. There is little research that examines demographic, clinic al and treatment factors associated with changes in physical symptoms, psychiatric symptoms and functional outcome in patients with somatize d depression or anxiety in primary care. Method. Factors associated wi th the outcome of psychologized or somatized depression or anxiety wer e derived from the literature. These factors were tested individually for their effects on changes in physical symptoms, psychiatric symptom s and functional outcome between baseline consultation with the genera l practitioner and 1 or 3 months later in 215 patients with somatized depression or anxiety. Individual factors associated with a particular outcome, demographic, DSM-IV diagnosis and treatment variables were e ntered into a multiple regression analysis. Results. Factors associate d with a better outcome on all three types of outcome measure were the absence of generalized anxiety disorder and/or simple or social phobi as, absence of physical pathology, and the prescription of fewer drugs , especially hypnotics or benzodiazepines. In addition, a better psych iatric symptom outcome was associated with the patients' perceived sat isfaction with the general practitioner's understanding or explanation of the patient's problems. A better functional outcome was associated with having a job, less distress over physical symptoms, not receivin g invalidity benefit and no referral to hospital. Conclusion. There ar e clinical and demographic factors associated with all types of short- term outcome in patients with somatized depression or anxiety but ther e are additional factors that are associated only with either psychiat ric or functional outcome.