%0 Journal Article
%T Diagnoses of Patients with Severe Subjective Health Complaints in Scandinavia: A Cross Sectional Study
%A Silje Maeland
%A Erik L. Werner
%A Marianne Rosendal
%A Ingibjorg H. Jonsdottir
%A Liv H. Magnussen
%A Holger Ursin
%A Hege R. Eriksen
%J ISRN Public Health
%D 2012
%R 10.5402/2012/851097
%X Background. A diagnosis is the basis of medical action, the key to various social privileges and national sick leave statistics. The objectives of this study were to investigate which diagnoses general practitioners in Scandinavia give patients with severe subjective health complaints, and what kind of treatments they suggested. Methods. One hundred and twenty-six self-selected general practitioners in Scandinavia diagnosed nine patients, presented as video vignettes, in a cross-sectional study. The main outcome measures were primary, secondary, and tertiary diagnoses. Results. The nine patients got between 13 and 31 different primary diagnoses and a large variety of secondary and tertiary diagnoses. Fifty-eight percent of the general practitioners chose different primary and secondary diagnoses, indicating that they judged the patients to have multimorbid complaints. The most commonly recommended treatment was referral to a psychologist, a mix of psychological and physical treatments, or treatment by the general practitioner. Conclusion. Scandinavian general practitioners give a large variety of symptom diagnoses, mainly psychological and general and unspecified, to patients with severe subjective health complaints. Referral to a psychologist or a mix of psychological or physical treatments was most commonly suggested to treat the patients. 1. Introduction Classification and medical coding of illness and disease capture snapshot views of a patient¡¯s health. A diagnosis is the basis of medical action and it is the key to various social privileges [1]. Simplified diagnostic taxonomies are used to classify illness and disease for epidemiological purposes. In European primary, care the predominant system for classification and coding is the International Classification of Primary Care, Second edition (ICPC-2) [2, 3]. A diagnosis is intended to give a precise name, description, and reason for a complaint, symptom, or disease. It is also expected to guide treatment, predict prognosis, and provide social acceptance of the complaints. In addition, it works as a key to social privileges in many European countries. Patients with severe subjective health complaints (SHCs) [4] frequently seek help from their general practitioner (GP), and severe SHC is the main reason for long-term sick leave [5]. These complaints are also known as medically unexplained symptoms (MUSs), somatoform disorders, functional somatic syndrome, bodily distress syndrome, somatization disorder [6, 7], or multisystem illness [8]. Despite having the same, or similar complaints, the preferred
%U http://www.hindawi.com/journals/isrn.public.health/2012/851097/