SOMATIZATION AND MEDICALLY UNEXPLAINED SYMPTOMS – PREVALENCE AND CORRELATES AMONG WOMEN AT NAHAQI – KPK, PAKISTAN

Abstract

Background: Medically unexplained physical symptoms or somatization accounts for about half of the OPD visits in primary care setup. These are unclear symptoms and cannot be explained by medical or neurologic conditions. They are associated with significant stigma and over burden utilization of medical services, and results in frustration both for clinician and for the patient. The study is aimed to determine the prevalence of somatization and its association with anxiety and depression among women at Nahaqi - Charsadda and also to find out the medically unexplained symptoms among women at Nahaqi. Study Design: Comparative cross sectional study. Setting: Village Nahaqi at Nahaqi Emergency Satellite Hospital (NESH) Charsadda – KPK, Pakistan. Period: September 2016 to March, 2017. Methodology: 100 females were included in this study after informed consent. American Psychiatric Association, Level 1 Cross-cutting Symptom Measure and Level 2 – Somatic Symptoms Adult Measure containing 23 and 15 questions respectively were used. Data were collected through interviews; entered and analyzed in SPSS. The study was conducted from September 2016 to March 2017. Results: 100 out of 120 women in the age range of 15 to 65 years, mean age 37.09 ± 12.08 years responded with response rate of 83.3%. Majority were illiterate (79 %), married (81 %) women. 86 % women reported unexplained body aches and pains. The prevalence of anxiety and depression among women at Nahaqi was 50 and 57 % respectively and all items were highly significant (P < 0.000) with somatic score categories (Minimal, Low, Medium, High). The prevalence of medically unexplained symptoms was found out to be 84 %, which includes all high and medium score cases. 59 women had 5 or more mild to moderate somatic complaints, while 49 reported 5 or more severe complaints. The most frequent complaints were aches and pains (headache, backache and musculo-skeletal aches and pains) followed by lack of energy, general asthenia. Conclusion: Nearly every second women was noted to have unexplained aches and pains, which shows that somatization is a frequent complaint in primary health settings. Majority cases were milder, however, patients showing severe impairment or more complaints they need particular attention. Although MUS result in extra stress on health services utilization in women visiting a rural health facility – Nahaqi; those with serious impairment shall be referred for psychiatric evaluation. A comprehensive medical, psycho-social model that involves community shall be formulated to address this issue.