SYMPTOMS IN THE COMMUNITY - PREVALENCE, CLASSIFICATION, AND PSYCHIATRIC COMORBIDITY

Background: While physical symptoms are the leading reason for outpati ent visits, a substantial proportion of physical complaints and ''mino r'' illnesses remain poorly understood. The purpose of our study was t o determine the prevalence, patient-attributed cause, and psychiatric comorbidity of symptoms in a general population. Methods: We analyzed data on 13 538 individuals interviewed in the Epidemiologic Catchment Area Program, a multicommunity mental health survey that used the Diag nostic Interview Schedule to determine the prevalence of psychiatric d isorders. The Diagnostic Interview Schedule inquires about 38 physical symptoms and includes a probing scheme to classify symptom seventy an d potential cause. We focused on 26 symptoms most germane to primary c are. Results: Of the 26 symptoms, 24 had been problems for more than 1 0% of persons at some point in their life, with the most common nonmen strual symptoms being joint pains (36.7%), back pain (31.5%), headache s (24.9%), chest pain (24.6%), arm or leg pain (24.3%), abdominal pain (23.6%), fatigue (23.6%), and dizziness (23.2%). Most symptoms (84%) were at some point considered major in that they interfered with routi ne activities or had led individuals to take medications or visit a ph ysician. Nearly one third of symptoms were either psychiatric or unexp lained, and most symptoms were associated with at least a twofold incr eased lifetime risk of a common psychiatric disorder. Conclusions: Sym ptoms in the community are prevalent as well as bothersome. Often lack ing an apparent physical explanation, such symptoms are associated wit h an increased likelihood of psychiatric disorders.