KENMERKEN VAN PATIENTEN MET DE DIAGNOSE 'PSYCHISCHE SURMENAGE' IN DE HUISARTSPRAKTIJK

Objective. To investigate the characteristics of general practitioners' patients given the diagnosis of 'surmenage' (French for 'nervous breakdown'). Design. Descriptive. Setting. General practices in Almere, the Netherlands. Method. Four groups of general practice attenders were selected based on the general practitioners' diagnosis: a group of surmenage patients (n = 106), a group of somatic patients without apparent psychological problems (n = 159), a group of patients with a psychosocial diagnosis (n = 136) and a group of patients with a psychiatric diagnosis (n = 57). Symptoms, social functioning, background data, life events and problems were collected by questionnaires. Results. Most surmenage patients were employed young adults. They experienced more work or study related problems than the other patients. They also experienced more other problems than the somatic patients but not more than the patients with a psychosocial or psychiatric diagnosis. More than half of the surmenage patients were on sick leave. The most important symptoms in surmenage patients were nervousness, brooding, fatigue and insomnia. On the basis of their symptoms the surmenage patients could be distinguished well from the somatic and psychosocial patients, but not from the patients with a psychiatric diagnosis. The surmenage patients had a shorter duration of symptoms than the patients with a psychosocial or a psychiatric diagnosis. The group of surmenage patients was very heterogeneous. Conclusion. The diagnosis of surmenage is associated with nonspecific psychological symptoms, a relatively recent onset, being employed, experiencing problems related to work or study, and being on sick leave. Patients diagnosed as suffering from surmenage by their general practitioner, form a heterogeneous group.