Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice

Background. Musculoskeletal illness is a common cause of absenteeism from w ork, workers' compensation, and disability retirement, and accounts for 9.3 % to 17% of patient contacts in general practice. To understand the increas e in self-reported musculoskeletal illness and to improve treatment and pre vention, it is important to know which factors to target when dealing with these patients. Aim. To investigate whether the prognosis for patients with musculoskeletal illness referred to physiotherapy from general practice can be predicted b y the presence of psychological distress and somatisation identified by a g eneral practitioner (GP) and standard questionnaires. Method. A multi-practice survey based on questionnaires (index and three-mo nth follow-up). Nine hundred and five consecutive patients referred to phys iotherapy from 124 different general practices in Denmark were included. Ou tcome measures were physical health change, sick leave, patient self-rated improvement, and change in use of medication. Results. Psychological distress and somatisation rated by both GPs and stan dard questionnaires acted with almost no exception as significant predictor s of all four outcome measures. Conclusion. Psychological distress and somatisation are important factors w hen considering preventive initiatives and treatment of patients with muscu loskeletal illness in general practice.