Sex and gender differences in primary care help-seeking for common somatic symptoms: a longitudinal study

Figures & data

Table 1. Characteristics of the study population at baseline (N = 8325).

		Male participants (N = 2709; 32.5%)	Female participants (N = 5616; 67.5%)
Age (years), mean (SD)		44.8 (12.7)	42.9 (13.0)
Gender index, median (IQR)		0.08 (0.02–0.30)	0.95 (0.82–0.99)
Educational level, N (%)	Low	905 (33.4%)	1724 (30.7%)
	Medium	968 (35.7%)	2229 (39.7%)
	High	836 (30.9%)	1663 (29.6%)
Symptom burden, mean SCL-90 SOM score (SD)		1.38 (0.37)	1.49 (0.41)
Chronic disease, N (%)	Present	1241 (45.8%)	3035 (54.0%)
	Absent	1468 (54.2%)	2581 (46.0%)
Self-rated health, N (%)	Good to excellent	2326 (87.1%)	4728 (85.4%)
	Poor to mediocre	345 (12.9%)	807 (14.6%)
New-onset symptom		5439	12,416
Help-seeking 6 weeks		70	185
Help-seeking 3 months		111	278

Table 2. Reported new-onset symptoms in Lifelines and concomitant GP contacts in 8325 participants.

New-onset common somatic symptom (ICPC)	Symptoms reported, N (%)	GP contacts within 6 weeks, N (%)	GP contacts within 3 months, N (%)
Headache (N01)	1868 (10.5%)	19 (7.5%)	26 (6.7%)
Dizziness (N17)	761 (4.3%)	17 (6.7%)	24 (6.2%)
Heart pain (K01)	483 (2.7%)	<10 (<3.9%)	<10 (2.6%)
(Lower) back pain (L02/L03)	2529 (14.2%)	88 (34.5%)	138 (35.5%)
Nausea (D09)	1406 (7.9%)	<10 (<3.9%)	<10 (<2.6%)
Muscle pain (L18)	3016 (16.9%)	20 (7.8%)	39 (10.0%)
Shortness of breath (R02)	633 (3.5%)	13 (5.1%)	17 (4.4%)
Hot-and-cold spells (A02)	1627 (9.1%)	<10 (<3.9%)	<10 (<2.6%)
Tingling extremities (N05)	1566 (8.7%)	10 (3.9%)	12 (3.1%)
Throat/swallowing problems (D21/R21)	798 (4.5%)	17 (6.7%)	25 (6.4%)
General tiredness (A04)	1698 (9.5%)	43 (16.9%)	66 (17.0%)
Arm/leg symptoms (L09/L14)	1470 (8.2%)	19 (7.5%)	28 (7.2%)
Total	17,855 (100.0%)	255 (100.0%)	389 (100.0%)

Table 3. Generalized linear mixed-effects models: estimated associations between independent variables and help-seeking within different time frames.

		Help-seeking (N = 17,855)
		Within 6 weeks	Within 3 months
Fixed effects		OR (95%CI)
Female sex		1.78 (1.13–2.80)	1.53 (1.05–2.21)
Femininity		0.67 (0.39–1.16)	0.76 (0.49–1.20)
Age		1.03 (1.02–1.04)	1.02 (1.01–1.03)
Presence of chronic disease		1.00 (0.76-1.31)	1.04 (0.84–1.30)
Educational level	Low	Ref.	Ref.
	Medium	1.22 (0.89–1.67)	0.95 (0.74–1.23)
	High	1.18 (0.84–1.66)	0.94 (0.71–1.24)
Symptom burden		0.98 (0.96–1.01)	0.99 (0.97–1.01)
Presence of symptom	Headache	0.78 (0.41–1.48)	0.74 (0.43–1.28)
	Dizziness	1.77 (0.92–3.41)	1.67 (0.97–2.90)
	Heart pain	0.47 (0.14–1.58)	0.54 (0.21–1.38)
	(Lower) back pain	2.67 (1.62–4.40)	3.00 (1.99–4.53)
	Nausea	0.29 (0.11–0.76)	0.31 (0.14–0.68)
	Muscle pain	0.48 (0.26–0.90)	0.65 (0.40–1.06)
	Shortness of breath	1.57 (0.77–3.19)	1.40 (0.76–2.56)
	Hot-and-cold spells	0.05 (0.01–0.32)	0.03 (0.01–0.22)
	Tingling extremities	0.47 (0.28–0.99)	0.38 (0.19–0.75)
	Throat problems	1.67 (0.87–3.21)	1.68 (0.98–2.90)
	General tiredness	2.10 (1.22–3.59)	2.24 (1.43–3.49)
	Heavy arms/legs	1.27 (0.68–2.41)	1.33 (0.78–2.28)

Data availability statement

Given the privacy of participants included in Lifelines and NPCD, the authors cannot publicly share the databases used in this study. Access to data can be requested by contacting Lifelines and NIVEL.