{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T18:09:55Z","timestamp":1790964595418,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Many primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cross-sectional design was used to interview 400 attendees. Men and women aged over 18\u2009years old without a psychiatric diagnosis were invited to participate. The Somatization scale of the Four-Dimensional Symptom Questionnaire was used to assess somatic symptom disorders. It is a valid tool to be used in a PHC setting. We used the Chi-square test and multivariable logistic regression to explore determinant variables.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Prevalence of SSD was 32.5% (95%CI\u2009=\u200927.9\u201337.1%). The most common symptoms were painful muscles (61.5%) followed by back pain (52.3%). Female gender [adjusted OR\u2009=\u20092.1 (95% CI\u2009=\u20091.2\u20133.7)], chronic diseases [adjusted OR\u2009=\u20092.4 (95%CI\u2009=\u20091.3\u20134.5)], depression [adjusted OR\u2009=\u20093.3 (95%CI\u2009=\u20092.0\u20135.5)], and anxiety [adjusted OR\u2009=\u20092.1 (95%CI\u2009=\u20091.2\u20133.6)] were all associated with SSD. In addition, frequent primary health care attendance was found to be associated with SSD [adjusted OR\u2009=\u20092.4 (95%CI\u2009=\u20091.4\u20134.1)].<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>SSD significantly higher among females, patients with chronic diseases, clients with anxiety and depressive disorders, and patients with frequent doctors\u2019 visits. Painful muscles and back pain are the most common symptom presented by patients, and this could be used initially by PHC physicians as a signal to consider for screening.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-021-06671-2","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:02:27Z","timestamp":1624924947000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Somatic symptom disorders and utilization of health services among Palestinian primary health care attendees: a cross-sectional study"],"prefix":"10.1186","volume":"21","author":[{"given":"Zaher","family":"Nazzal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beesan","family":"Maraqa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marah","family":"Abu Zant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layali","family":"Qaddoumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Abdallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"issue":"3","key":"6671_CR1","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/S1058-9139(05)80079-8","volume":"2","author":"K Kroenke","year":"1993","unstructured":"Kroenke K. 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Informed consent was obtained from all participants. Interviews were carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki). Approval of the An-Najah National University institutional review board was obtained. Participants\u2019 privacy and confidentiality were ensured.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"\u201cNot applicable.\u201d","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"\u201cThe authors declare that they have no competing interests\u201d in this section.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"615"}}