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Studying ICD-11 Primary Health Care bodily stress syndrome in Brazil: do many functional disorders represent just one syndrome?
Fortes, Sandra; Ziebold, Carolina; Reed, Geoffrey M; Robles-Garcia, Rebeca; Campos, Monica R; Reisdorfer, Emilene; Prado, Ricardo; Goldberg, David; Gask, Linda; Mari, Jair J.
  • Fortes, Sandra; Universidade do Estado do Rio de Janeiro (UERJ). Faculdade de Ciências Médicas. Rio de Janeiro. BR
  • Ziebold, Carolina; Universidade Federal de São Paulo (UNIFESP). Departamento de Psiquiatria. São Paulo. BR
  • Reed, Geoffrey M; World Health Organization (WHO). Geneva. CH
  • Robles-Garcia, Rebeca; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. CDMX. MX
  • Campos, Monica R; Fundação Oswaldo Cruz (Fiocruz). Escola Nacional de Saúde Pública Sergio Arouca (ENSP). Rio de Janeiro. BR
  • Reisdorfer, Emilene; Center for Addition and Mental Health. Ontario. CA
  • Prado, Ricardo; Universidade Federal de São Paulo (UNIFESP). Departamento de Psiquiatria. São Paulo. BR
  • Goldberg, David; Institute of Psychiatry, King's College London. London. GB
  • Gask, Linda; University of Manchester. Manchester. GB
  • Mari, Jair J; Universidade Federal de São Paulo (UNIFESP). Departamento de Psiquiatria. São Paulo. BR
Rev. bras. psiquiatr ; 41(1): 15-21, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-985361
ABSTRACT

Objective:

Disorders characterized by "distressing unexplained somatic symptoms" are challenging. In the ICD-11 Primary Health Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (ICD-11 PHC), a new category, bodily stress syndrome (BSS), was included to diagnose patients presenting unexplained somatic symptoms. The present study investigated the association of BSS with anxiety, depression, and four subgroups of physical symptoms in a Brazilian primary health care (PHC) sample.

Methodology:

As part of the international ICD-11 PHC study, 338 patients were evaluated by their primary care physicians, followed by testing with Clinical Interview Schedule (CIS-R) and World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0). BSS was diagnosed in the presence of at least three somatic symptoms associated with incapacity. The association between anxiety, depression, and four subgroups of physical symptoms with being a BSS case was analyzed.

Results:

The number of somatic symptoms was high in the overall sample of 338 patients (mean = 8.4), but even higher in the 131 BSS patients (10.2; p < 0.001). Most BSS patients (57.3%) had at least three symptoms from two, three, or four subgroups, and these were associated with anxiety and depression in 80.9% of these patients. The symptom subgroup most strongly associated with "being a BSS" case was the non-specific group (OR = 6.51; 95%CI 1.65-24.34), followed by musculoskeletal (OR = 2,31; 95%CI 1.19-4.72).

Conclusion:

Somatic symptoms were frequent in a sample of PHC patients in Brazil. In the present sample, one third were BSS cases and met the criteria for at least two symptom subgroups, supporting the hypothesis that different functional symptoms are related to each other.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Anxiety Disorders / Somatoform Disorders / International Classification of Diseases / Depressive Disorder Type of study: Practice guideline / Observational study / Prevalence study / Qualitative research / Risk factors Limits: Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Rev. bras. psiquiatr Year: 2019 Type: Article Affiliation country: Brazil / Canada / Mexico / Switzerland / United kingdom Institution/Affiliation country: Center for Addition and Mental Health/CA / Fundação Oswaldo Cruz (Fiocruz)/BR / Institute of Psychiatry, King's College London/GB / Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz/MX / Universidade Federal de São Paulo (UNIFESP)/BR / Universidade do Estado do Rio de Janeiro (UERJ)/BR / University of Manchester/GB / World Health Organization (WHO)/CH

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Full text: Available Index: LILACS (Americas) Main subject: Anxiety Disorders / Somatoform Disorders / International Classification of Diseases / Depressive Disorder Type of study: Practice guideline / Observational study / Prevalence study / Qualitative research / Risk factors Limits: Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Rev. bras. psiquiatr Year: 2019 Type: Article Affiliation country: Brazil / Canada / Mexico / Switzerland / United kingdom Institution/Affiliation country: Center for Addition and Mental Health/CA / Fundação Oswaldo Cruz (Fiocruz)/BR / Institute of Psychiatry, King's College London/GB / Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz/MX / Universidade Federal de São Paulo (UNIFESP)/BR / Universidade do Estado do Rio de Janeiro (UERJ)/BR / University of Manchester/GB / World Health Organization (WHO)/CH