Psychological symptoms in primary care: which symptoms persist more?

Asma Chaabouni, Juul Houwen, Hans Peters, Kees Van Boven, Iris Walraven, Henk Schers, Tim Olde Hartman

Keywords: Psychological symptoms, persistent symptoms, management strategies

Background:
Psychological symptoms that could not be attributed to a psychiatric disease play an important part in primary care. More than 20% of all consultations are about psychological symptoms. More than half of the patients with psychological symptoms have persistent symptoms. General practitioners (GPs) often experience difficulties in the care of patients with persistent psychological symptoms.

Research questions:
Relevance of the study: Because of the high frequency of patients with psychological symptoms in primary care and the challenges that GPs encounter when dealing with them, it is important to gain a broad insight into the scale of (persistent) psychological symptom diagnoses in order to adjust management strategies.
Aim of the study: Investigate clinical characteristics and GP management strategies of patients with (persistent) psychological symptoms and study which psychological symptoms persist more.

Method:
A retrospective cohort study. We will collect data from the Family- Medicine Network (FaMe-Net) dataset, a Dutch data registry including more than 32 GPs coding medical files from 1978. We will include all patients, aged more than 18 years, who visited their GP in 2018 for a psychological symptom diagnosis according to the International Classification of Primary Care (ICPC-2; codes P01-P29). An Episode of Care (EoC) is defined as ‘a health problem in an individual from the first until the last encounter with a health care provider’. We established for each symptom diagnosis the duration of the EoC. Persistent psychological symptoms are defined when the EoC last more than one year.

Results:
Expected results: We will determine the incidence and prevalence rates of (persistent) psychological symptoms. Additionally, we will study patients' characteristics (age, sex, marital status, comorbidities, level of education, previous psychological physical and/or sexual abuse, marital, etc) and GP management strategies (referrals, diagnostic and therapeutic investigations, etc) of patients with (persistent) psychological symptoms.

Conclusions:
N/A

Points for discussion: