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Risk Factors for Unexplained Symptoms After a Disaster: A Five-Year Longitudinal Study in General Practice

Received November 14, 2006; revised April 27, 2007; accepted May 18, 2007. From the National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; the Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands; the Institute for Psychotrauma (IvP), Zaltbommel, the Netherlands; the Centre for Biostatistics, Utrecht University, Utrecht, the Netherlands; and the Julius Center, Utrecht University, Utrecht, the Netherlands. Send correspondence and reprint requests to Bellis van den Berg, A. van Leeuwenhoeklaan 9 (postbak 10), Erik Lebret, Ph.D., Linda Grievink, Ph.D., 3720 BA Bilthoven, the Netherlands. e-mail: bellis.van.den.berg{at}rivm.nl
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Medically unexplained symptoms (MUS) are a common reason to seek medical care. When presented to the general practitioner (GP), more than three-quarters of symptoms such as stomach ache, headache, and pain in bones and muscles cannot be explained by a medical disorder. OBJECTIVE: The authors examined the course of MUS presented to the GP in the 1 year before the disaster and in the 4 years after a disaster in order to study the risk factors for MUS. METHOD: Data were extracted from the electronic medical records of survivors and from a questionnaire (N=1,216). RESULTS: Although the mean number of MUS was significantly increased statistically in the first 2 years post-disaster, the increase was not clinically significant. CONCLUSION: The authors identified several important risk factors, such as immigrant status and psychological problems, that are easy for GPs to recognize. Despite this, the sensitivity of the regression model was relatively low.

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