Comorbid painful physical symptoms and anxiety: Prevalence, work loss and help-seeking

Background: There is evidence that painful physical symptoms (PPS) are increased in patients with anxiety disorder (AD). This survey reports the 12-month prevalence and sociodemographic characteristics of PPS in subjects with and without AD, taking into account somatic comorbidity. In addition, the impact of PPS on work loss days (WLDs) and help-seeking was examined. Methods: In a cross-sectional, population-based study, a representative random sample of non-institutionalised adults from Belgium, France, Germany, Italy, The Netherlands and Spain (N=21,425) was interviewed using the World Mental Health Composite Diagnostic Inter-view (CIDI 3.0 of the WHO). 8296 respondents provided data on the occurrence of PPS, from which 5489 respondents reported the number of work loss days. Results: PPS were reported by 28% of respondents without AD and by 45% in those with AD. Female gender, higher age and lower educational level were predictive of PPS. No additive effect of AD and PPS was found on the WLD score, neither did the presence or not of a comorbid somatic disorder change the findings. Finally, respondents with both AD and PPS had numerically higher rates of help-seeking for emotional reasons (20.8% vs. 15.0% for respondents with AD but not PPS) and delayed their help-seeking for a numerically shorter period of time (289 vs. 413 days, respectively). Limitations: The most important limitation of this study was its reliance on self-reported data about somatic disorders. Conclusion: Approximately 45% of persons with anxiety disorder also reported the presence of PPS. No additive effect of AD and PPS was found on the WLD score, and the presence of PPS in AD does not delay help-seeking for emotional problems. (C) 2008 Elsevier B.V. All rights reserved.