• Alberto Febles and Jane Ogden.
• Department of Health Psychology, University of Surrey, Guildford, Surrey, UK.
• Br J Gen Pract. 2005 Apr 1; 55 (513): 274279274-9.

BackgroundStress has become an increasingly common presentation in general practice. This may relate to an increase in stress in people's lives or a change in the meaning of stress and its conceptualisation as a legitimate problem for the GP.AimTo explore patients' beliefs about stress, their association with help-seeking behaviour, and to examine differences by ethnic group.Design Of StudyCross-sectional survey of general practice patients attending to see their GP.SettingAn inner-city London practice.MethodConsecutive general practice patients completed a questionnaire, which involved rating a series of symptoms for the extent to which they were associated with stress and describing their help-seeking behaviour. In total, 548 patients completed the questionnaire. Most patients described themselves as black Caribbean (n = 163), black African (n = 48), or white British (n = 187).ResultsThe symptoms most frequently associated with stress were sleeping problems, feeling depressed, feeling panicky, having high blood pressure and feeling anxious; feeling ashamed, experiencing indigestion, having diarrhoea, feeling hot or cold, and suffering from constipation were least commonly associated to stress. This model of stress did not vary by ethnic group. Ethnic group differences were found for the association between the model of stress and help-seeking behaviour. Although white British patients consistently reported that the more a symptom was seen as indicative of stress, the more likely they would be to visit the doctor for that symptom, this association was not found for either black Caribbean or black African patients.ConclusionsThe belief that stress-related symptoms are a legitimate problem for the GP is not universal and varies according to ethnic group. Stress is used by different patients in different ways and offers a variable pathway to the doctor.

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