Age, Affective Distress, and Illness Detection in Patients Evaluated for Gastrointestinal Complaints

A study of 260 patients was conducted in 1990 using a questionnaire that was designed to measure and assess their recall of symptom patterns, symptom distress levels, symptom interpretation, and physician-recommended treatment plans. The questionnaire was mailed 6–18 months after they had undergone a gastrointestinal workup for unexplained chest or abdominal pain. The authors found comparably high rates of both younger patients (age < 65) and older patients (age ≥ 65) reporting symptom patterns sufficient to meet DSM-III criteria for panic, generalized anxiety, and depressive disorders. For younger but not older patients, the number of symptom complaints was related to their recall of a stress-related diagnosis made by the physician, which was less frequent for older patients. The older patients less often identified their symptoms as tension-related. Further research is needed concerning symptom reporting, illness attribution, and physician recognition of emotional etiology among elderly and younger patients with somatizing disorders.