Symptoms as a surmountable challenge: Symptom reporting and self-rated health in the population and in general practice

Abstract

Symptoms are experienced by most people every day. However, we know less about how symptoms are associated with self-rated health, diagnoses, life-stressors and unexplained conditions. The aims of this thesis were to explore symptom reporting and self-rated health in a population and in general practice patients, and to study factors associated with the report of poor self-rated health. Self-report questionnaires from 3225 inhabitants in Ullensaker municipality and linked questionnaires to 866 patients in general practice and their 47 general practitioners were included in the study. In the population, 91% reported at least one symptom the last month, and 47% reported 6 or more symptoms. Women reported more symptoms than men (mean 6.7 vs 5.1). Symptoms were frequent in all age groups, also among the youngest (24-26 years). Most symptoms were reported by those with poor self-rated health (13.4), recipients of social security benefits (10.2) and unemployed (7.9). The most common symptoms among patients in general practice the last week were tiredness (44%), lower back pain (43%), headache (41%), neck pain (39%), shoulder pain (36%) and sleep problems (35%). Patients diagnosed with asthenia (11.2) and depression/anxiety (10.7) reported the highest number of symptoms, and patients with hypertension the lowest (5.6). There was a strong association between poor self-rated health and the report of a high number of symptoms both in the population and in patients in general practice. Current and chronic diagnoses, life stressors or medically unexplained conditions were not associated with poor self-rated health in a multivariate analysis. Doctors should be made aware that patients with many symptoms have an increased risk of developing poor health, partly independent of diagnosis. The strong association between poor self-rated health and a high number of symptoms also points out the clinical utility of drawing the complete picture of symptoms in a patient from time to time.