Persistent unexplained physical symptoms: a prospective longitudinal cohort study in UK primary care

Area of Science:

• General Practice
• Psychosomatic Medicine
• Longitudinal Cohort Studies

Background:

• Unexplained physical symptoms (UPS) are prevalent in primary care settings.
• Limited understanding exists regarding the long-term prognosis of UPS.

Purpose of the Study:

• To assess the persistence of somatic symptoms at six months in patients with multiple UPS.
• To identify prognostic factors linked to worsening symptom scores.

Main Methods:

• Prospective longitudinal cohort study in UK general practices.
• Inclusion of adults with at least three UPS.
• Assessment of symptom severity (PHQ-15), wellbeing, and history, with six-month follow-up.

Main Results:

• 55% of participants still reported UPS at six months; only 11% achieved complete resolution.
• Higher baseline symptom severity, female gender, poorer physical functioning, childhood abuse, and perceived financial distress predicted worse outcomes.
• 42% of symptoms remained under investigation at follow-up.

Conclusions:

• A significant proportion of patients experience persistent UPS at six months.
• General practitioners (GPs) require awareness of UPS persistence and associated risk factors for improved care planning.
• Development of prognostic tools is crucial for predicting poor outcomes in UPS patients.