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The association of psychological factors and healthcare use with the discrepancy between subjective and objective respiratory-health complaints in the general population

Published online by Cambridge University Press:  20 March 2018

Sanna Selinheimo ,
Tuula Vasankari ,
Markus Jokela ,
Merja Kanervisto ,
Sami Pirkola ,
Jaana Suvisaari  and
Tiina Paunio
Sanna Selinheimo*
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland Department of Health, National Institute for Health and Welfare, Helsinki, Finland Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Tuula Vasankari
Affiliation:
Finnish Lung Health Association, Helsinki, Finland Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
Markus Jokela
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Merja Kanervisto
Affiliation:
Independent Science Researcher Ylöjärvi, Finland
Sami Pirkola
Affiliation:
Health Sciences, and University Hospital Psychiatric Department, University of Tampere, Tampere, Finland
Jaana Suvisaari
Affiliation:
Department of Health, National Institute for Health and Welfare, Helsinki, Finland
Tiina Paunio
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland Department of Health, National Institute for Health and Welfare, Helsinki, Finland Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
*
Author for correspondence: Sanna Selinheimo, E-mail: sanna.selinheimo@ttl.fi or Tiina Paunio, E-mail: tiina.paunio@helsinki.fi
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Abstract

Background

We examined the prevalence of self-perceived respiratory symptoms (SRS) in the absence of any objective findings of respiratory pathology, and the association of such prevalence with psychological factors and healthcare use in the general population.

Methods

The study was conducted among a nationally representative sample of Finnish adults (BRIF8901). Respiratory functioning was measured by a spirometry test. Structured questionnaires were used to measure SRS, physician visits and psychological factors of alexithymia, sense of coherence, illness worry and common mental disorders. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder, determined in a diagnostic interview, were excluded, giving a sample comprising 4544 participants.

Results

Twenty-six per cent of the general population and 36% of those with no diagnosed severe psychiatric disorder or respiratory disease experienced SRS despite a normal spirometry result. Psychological factors were associated with SRS (0.0001 < p < 0.032), and on the number of physician visit explaining 42.7% of the difference in visits between individuals with and without SRS, respectively. Illness worry was associated most strongly with SRS [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.19–1.41, p < 0.0001] and higher numbers of physician visits (OR 1.35, CI 1.32–1.38, p < 0.00001), even after several adjustments.

Conclusions

Respiratory symptoms without objective findings are common in the general population. The study results underline the role of psychological factors in the reporting of respiratory symptoms and the associated medical burden, thereby indicating the functional nature of the symptomatology.

Keywords

Alexithymiahealth anxietyhealthcare useillness perceptionpopulation-based studyrespiratory symptomssense of coherencesubjective health complaints
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 1 , January 2019 , pp. 121 - 131
Copyright
Copyright © Cambridge University Press 2018 

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