Predictors of Seeking Psychotherapy in Primary Care Patients with High Somatic Symptom Burden

Abstract

Many primary care patients with high somatic symptom burden do not initiate mental health treatment. Using a cross-sectional design, this study aimed to identify predictors of psychotherapy seeking behavior for patients with high somatic symptom burden within the last 12 months. Data from 20 primary care practices were analyzed. Patients with high somatic symptom burden were identified using the Patient Health Questionnaire, structured interviews, and information from primary care physicians (PCPs). Within the final sample of 142 patients, 54 (38.03%) had been seeking psychotherapy. More severe somatic symptoms, taking psychopharmacological medication and frequently discussing psychosocial distress with PCPs, were associated with psychotherapy seeking behavior. Depressive and anxiety symptoms, and whether PCPs had diagnosed a somatoform disorder or recommended psychotherapy, were not. The results underline the importance of patient-related factors in psychotherapy seeking behavior.

Keywords:

• primary care
• psychotherapy
• somatoform disorders
• somatic symptoms
• somatic symptom burden

Ethics

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Ethics approval was obtained from the local ethics committee (Ethik-Kommission der Ärztekammer Hamburg; 28/09/2011, ref. PV3728).

Acknowledgments

We thank Dr. Alexandra Murray for critically reviewing this paper. Our appreciation also goes to all network partners and patients who participated in Sofu-Net.

Declaration of conflicting interests

The authors declare that there is no conflict of interest.

Consent to participate

Participants gave written consent for data to be collected and published anonymously.

Additional information

Funding

This work was supported by the German Federal Ministry of Education and Research (BMBF). It was part of a health care research project within the Hamburg metropolitan area (‘psychenet – Hamburg Network for Mental Health’; Subproject: ‘Somatoform and functional disorders’). Grant number: 01KQ1002B.