The overlap of somatic, anxious and depressive syndromes: A population-based analysis

•In the general population every tenth individual reports somatic, anxious and depressive (SAD) syndromes.•Single SAD syndromes are comorbid in one-third of the cases.•The number of single SAD syndromes is strongly associated with increased health care use.•The overlap of single SAD syndromes explains the greatest part of variance in health care use.

ObjectiveThe comorbidity of somatic, anxious and depressive syndromes occurs in half of all primary care cases. As research on this overlap of syndromes in the general population is scarce, the present study investigated the prevalence of the overlapping syndromes and their association with health care use.MethodA national general population survey was conducted between June and July 2012. Trained interviewers contacted participants face-to-face, during which, individuals reported their health care use in the previous 12 months. Somatic, anxious and depressive syndromes were assessed using the Somatic Symptom Scale-8 (SSS-8), Generalized Anxiety Disorder-2 (GAD-2) and Patient Health Questionnaire-2 (PHQ-2) respectively.ResultsOut of 2510 participants, 236 (9.4%) reported somatic (5.9%), anxious (3.4%) or depressive (4.7%) syndromes, which were comorbid in 86 (3.4%) cases. The increase in the number of syndromes was associated with increase in health care visits (no syndrome: 3.18 visits vs. mono syndrome: 5.82 visits vs. multi syndromes: 14.16 visits, (F(2,2507) = 149.10, p < 0.00001)). Compared to each somatic (semi-partial r2 = 3.4%), anxious (semi-partial r2 = 0.82%) or depressive (semi-partial r2 = 0.002%) syndrome, the syndrome overlap (semi-partial r2 = 6.6%) explained the greatest part of variance of health care use (change_inR2 = 11.2%, change_inF(3,2499) = 112.81, p < 0.001.)ConclusionsThe overlap of somatic, anxious and depressive syndromes is frequent in the general population but appears to be less common compared to primary care populations. To estimate health care use in the general population the overlap of somatic, anxious and depressive syndromes should be considered.