Prevalence and detection of medically unexplained symptoms among out-patients in a Primary Health Care setting in South-west Nigeria

Background: Medically unexplained symptoms are frequently encountered by physicians at the primary care level. The complexity lies in the ill-defined nature of the multiple physical symptoms and the similarity to several organic disorders. Objective: To determine the prevalence of medically unexplained symptoms and relate this to physicians detection rate in a primary care setting in South-west, Nigeria. Methods: The study was a cross-sectional, descriptive study of consecutive patients of the General Out-patient Department of Olabisi Onabanjo University Teaching  Hospital, Sagamu, Ogun State. Interviews were conducted on 472 participants using a purposely designed socio-demographic questionnaire and the self-administered Patient Health Questionnaire -15 to screen for somatic symptoms. Results: The ages of the participants ranged from 18 years to 90 years with the mean of 52.7±20.9 years. Out of the 472 participants, 225 (47.7%) met the criteria for medically unexplained symptoms using the Patient Health Questionnaire (PHQ). Across ages, medically unexplained symptoms were more often diagnosed among younger age groups especially those close to the age of 35 years (59.2%) [χ2 = 12.34, p = 0.02]. There were significant differences in the prevalence of somatisation across different levels of education [χ2= 9.78, p = 0.03]. Physicians were able to diagnose psychological disorders in 12.4% of participants (n = 28) with somatisation disorders. Conclusion: There was a moderately high prevalence of medically unexplained symptoms in primary health care settings and physicians’ detection rate of somatisation was also low. Physicians in primary health care should have a high index of suspicion for somatisation.