The relationship between various psychosocial factors and physical symptoms reported during primary-care health examinations

Objectives: The aim of the study was to determine indicators for psychosocial factors and to investigate the associations between them and physical complaints, as well as to examine possible gender-dependent differences. Methods: This was an observational (cross-sectional) study in primary care (health examinations in several Austrian regions); participants were 312 men and 374 women aged 19-60 years. The impact of psychosocial factors on ten physical symptoms (cardiac complaints, dyspnea, gastric complaints, headaches, joint or muscle pain, dry skin, hearing impairment, tinnitus, decrease of strength and endurance, and insomnia) was analyzed using logistic regression analyses and multiple linear regression models. Results: People with psychosocial stress or dissatisfaction exhibited a higher probability of reporting at least one physical symptom. Age-adjusted odds ratios (95%CI) were as follows: pressure at work 1.72 (1.08-2.73) in men and 2.53 (1.46-4.39) in women, social stress in the workplace 3.37 (1.41-8.05) in men and 3.09 (1.01-9.43) in women, sexual dissatisfaction 4.48 (1.47-13.62) in men and 1.77 (0.80-3.96) in women, discomfort in family/partnership 4.71 (1.34-16.57) in men and 1.76 (0.66-4.67) in women. Among men, the psychosocial parameter most strongly related to the number of physical symptoms was discomfort in family/partnership, followed by social stress in the workplace, sexual dissatisfaction, and pressure at work with means of 2.00, 1.27, 0.92 and 0.33 symptoms respectively ( linear regression model, adjusted for age). Among women the strongest association found was also with discomfort in family/partnership, followed by sexual dissatisfaction, pressure at work and social stress in the workplace with means of 1.32, 1.20, 0.58 and 0.50 symptoms respectively. Conclusions: The reporting of physical symptoms is often associated with psychosocial factors and these should be taken into account during primary care and, where appropriate, should be further clarified. There are unexpected, gender-related patterns in the association of different psychosocial factors with physical symptoms that warrant further investigation.