• Asma Chaabouni, Juul Houwen, Iris Walraven, Kees van Boven, Hans Peters, Henk Schers, and Tim Olde Hartman.
• From the Department of primary and community care, Radboud Institute of Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands (AC, JH, KVB, HP, HS, TOH); Department of health evidence, Radboud Institute of Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands (IW). asma.chaabouni@radboudumc.nl.
• J Am Board Fam Med. 2023 May 8; 36 (3): 477492477-492.

IntroductionSymptom diagnoses are diagnoses used in primary care when the relevant diagnostic criteria of a disease are not fulfilled. Although symptom diagnoses often get resolved spontaneously without a clearly defined illness nor treatment, up to 38% of these symptoms persist more than 1 year. It is largely unknown how often symptom diagnoses occur, which symptoms persist, and how general practitioners (GPs) manage them.AimExplore morbidity rates, characteristics and management of patients with nonpersistent (≤1 year) and persistent (>1 year) symptom diagnoses.MethodsA retrospective cohort study was performed in a Dutch practice-based research network including 28,590 registered patients. We selected symptom diagnosis episodes with at least 1 contact in 2018. We performed descriptive statistics, Student's T and χ2 tests to summarize and compare patients' characteristics and GP management strategies in the nonpersistent and persistent groups.ResultsThe incidence rate of symptom diagnoses was 767 episodes per 1000 patient-years. The prevalence rate was 485 patients per 1000 patient-years. Out of the patients who had a contact with their GPs, 58% had at least 1 symptom diagnosis, from which 16% were persistent (>1 year). In the persistent group, we found significantly more females (64% vs 57%), older patients (mean: 49 vs 36 years of age), patients with more comorbidities (71% vs 49%), psychological (17% vs 12%) and social (8% vs 5%) problems. Prescriptions (62% vs 23%) and referral (62.7% vs 30.6%) rates were significantly higher in persistent symptom episodes.ConclusionSymptom diagnoses are highly prevalent (58%) of which a considerable part (16%) persists more than a year.© Copyright by the American Board of Family Medicine.

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