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

Abstract

BACKGROUND: Musculoskeletal illness is a common cause of absenteeism from work, workers' compensation, and disability retirement, and accounts for 9.3% to 17% of patient contacts in general practice. To understand the increase in self-reported musculoskeletal illness and to improve treatment and prevention, 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 by the presence of psychological distress and somatisation identified by a general practitioner (GP) and standard questionnaires. METHOD: A multi-practice survey based on questionnaires (index and three-month follow-up). Nine hundred and five consecutive patients referred to physiotherapy from 124 different general practices in Denmark were included. Outcome 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 standard questionnaires acted with almost no exception as significant predictors of all four outcome measures. CONCLUSION: Psychological distress and somatisation are important factors when considering preventive initiatives and treatment of patients with musculoskeletal illness in general practice.