Wednesday, 20 August 2003
This presentation is part of : Interface of Medicine and Psychiatry in Psychogeriatrics I

S071-002 Somatization Among Older Primary Care Attenders

Bart Sheehan, School of Health and Social Studies, School of Health and Social Studies, University of Warwick, Coventry, United Kingdom

Objective: To establish the prevalence, outcome, associations, and implications for attending of somatization among older primary care attenders.

Design: A prospective cohort study in which 140 older primary care attenders in Oxford were interviewed and followed up after 10 months.

Materials and Methods: 140 older primary attenders were recruited and interviewed by a researcher. Each was rated on measures of

1. Somatization

2. Psychiatric diagnosis (GMS-AGECAT)

3. Physical health status

4. Demographics

5. Quality of life

6. Primary care attending.

123 were available for repeat assessment after 10 months. A GP measure of somatization was also rated.

Results: Somatized symptoms were common and persistent, as were somatic attributions for physical symptoms. As a syndrome, including inappropriate attending, it was common but transient. GPs felt that most older patients had some psychological component to physical symptoms. The strongest associations of somatization were with female sex, high attendance rates, not working, antidepressant prescription, depression and physical illness. The strongest predictors of high attending were low perceived support and somatized symptoms. Depressed older patients (n=26) endorsed a set of symptoms similar to those found in chronic fatigue syndrome.

Conclusion: Somatization is common among older primary care attenders. Its associations are similar to those found among younger populations. Strategies to prevent somatization may include limiting medical response to unexplained symptoms and preservation of societal role.

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