The outcome of medically unexplained symptoms—Will DSM-V improve on DSM-IV somatoform disorders?

2009 ◽  
Vol 66 (5) ◽  
pp. 379-381 ◽  
Author(s):  
Francis Creed
Keyword(s):  
Somatoform Disorders ◽  
Medically Unexplained Symptoms ◽  
Dsm V ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Dsm Iv

scholarly journals Psychiatric characteristics of older persons with medically unexplained symptoms: A comparison with older patients suffering from medically explained symptoms

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
D. J. C. Hanssen ◽  
T. J. W. van Driel ◽  
P. H. Hilderink ◽  
C. E. M. Benraad ◽  
P. Naarding ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Older Patients ◽  
Older Persons ◽  
Somatoform Disorders ◽  
Medically Unexplained Symptoms ◽  
Later Life ◽  
Healthcare Settings ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Dsm Iv

Abstract Background. Empirical studies on the clinical characteristics of older persons with medically unexplained symptoms are limited to uncontrolled pilot studies. Therefore, we aim to examine the psychiatric characteristics of older patients with medically unexplained symptoms (MUS) compared to older patients with medically explained symptoms (MES), also across healthcare settings. Methods. A case–control study including 118 older patients with MUS and 154 older patients with MES. To include patients with various developmental and severity stages, patients with MUS were recruited in the community (n = 12), primary care (n = 77), and specialized healthcare (n = 29). Psychopathology was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria (Mini-International Neuropsychiatric Interview) and by dimensional measures (e.g., psychological distress, hypochondriasis, and depressive symptoms). Results. A total of 69/118 (58.5%) patients with MUS met the criteria for a somatoform disorder according to DSM-IV-TR criteria, with the highest proportion among patients recruited in specialized healthcare settings (p = 0.008). Patients with MUS had a higher level of psychological distress and hypochondriasis compared to patients with MES. Although psychiatric disorders (beyond somatoform disorders) were more frequently found among patients with MUS compared to patients with MES (42.4 vs. 24.8%, p = 0.008), this difference disappeared when adjusted for age, sex, and level of education (odds ratio = 1.7 [95% confidence interval: 1.0–3.0], p = 0.070). Conclusions. Although psychological distress is significantly higher among older patients with MUS compared to those with MES, psychiatric comorbidity rates hardly differ between both patient groups. Therefore, treatment of MUS in later life should primarily focus on reducing psychological distress, irrespective of the healthcare setting patients are treated in.

scholarly journals Exploration of DSM-IV Criteria in Primary Care Patients With Medically Unexplained Symptoms

2005 ◽  
Vol 67 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Robert C. Smith ◽  
Joseph C. Gardiner ◽  
Judith S. Lyles ◽  
Corina Sirbu ◽  
Francesca C. Dwamena ◽  
...  
Keyword(s):  
Primary Care ◽  
Medically Unexplained Symptoms ◽  
Medically Unexplained ◽  
Primary Care Patients ◽  
Unexplained Symptoms ◽  
Dsm Iv

Factors influencing adherence to therapeutic recommendations made after diagnostic reassessment of medically unexplained symptoms in children and adolescents

2019 ◽  
Vol 25 (1) ◽  
pp. 62-77
Author(s):  
Sam LB Bonduelle ◽  
Johan Vanderfaeillie ◽  
Katrien Denijs ◽  
Annik Lampo ◽  
Lindita Imeraj
Keyword(s):  
Children And Adolescents ◽  
Influencing Factors ◽  
Somatoform Disorders ◽  
Medically Unexplained Symptoms ◽  
Primary Outcome Measure ◽  
Influential Factors ◽  
Cross Sectional ◽  
Medically Unexplained ◽  
Therapeutic Recommendations ◽  
Unexplained Symptoms

Background: Medically unexplained symptoms (MUS) are common among children and adolescents and may be highly impairing. Even after long diagnostic and/or therapeutic trajectories, many of these children and their parents feel dissatisfied with the advice and therapies they were given. Objectives: After a 2-week hospitalisation for somatic and psychiatric reassessment, children and their families were given recommendations for further treatment. This study evaluates which of these recommendations were carried out (primary outcome measure) and which factors influenced the (non-)adherence to therapeutic advice. Methods: Parents of 27 children aged 7–17 with impairing MUS took part in a structured telephone survey to assess adherence to and perceived effectiveness of therapeutic recommendations (cross-sectional study). Influencing factors were analysed retrospectively. Results: Psychotherapy was recommended to all 27 patients and their families; 19 of them (70.4%) carried out this advice. When physiotherapy was recommended, adherence proved lower (6/22 children; 27.3%). No influencing factors were found to have a statistically significant correlation with adherence. Effect sizes may be indicative of clinically relevant influential factors, but should be considered cautiously. Conclusion: Results suggest that more efforts need to be made to ensure adherence to therapeutic recommendations. Known risk factors for non-adherence to treatments for chronic somatic disorders may not apply for children with somatoform disorders.

scholarly journals Medically Unexplained Symptoms and Somatoform Disorders: Diagnostic Challenges to Psychiatrists

2009 ◽  
Vol 72 (5) ◽  
pp. 251-256 ◽  
Author(s):  
Cheng-Ta Li ◽  
Yuan-Hwa Chou ◽  
Kai-Chun Yang ◽  
Cheng-Hung Yang ◽  
Ying-Chiao Lee ◽  
...  
Keyword(s):  
Somatoform Disorders ◽  
Medically Unexplained Symptoms ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Being a botanist and a gardener: using diagnostic frameworks in general practice patients with medically unexplained symptoms

2013 ◽  
Vol 19 (2) ◽  
pp. 90 ◽  
Author(s):  
Louise Stone
Keyword(s):  
Somatoform Disorders ◽  
Medically Unexplained Symptoms ◽  
Multiple Perspectives ◽  
Medical Specialties ◽  
Mixed Methods Approach ◽  
Evidence Based Treatment ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Reliable Classification ◽  
The Way

Patients with multiple medically unexplained symptoms commonly seek treatment in primary care. Many of these patients seem to have a psychological ‘core’ to their illness that affects the way they experience, conceptualise and communicate their distress. There is considerable debate around diagnosis for this group of patients. Existing diagnoses include somatoform disorders in psychiatry and functional disorders in the medical specialties. Some clinicians use the term ‘heartsink’ patients, which reflects the interpersonal frustration inherent in some therapeutic relationships. A good diagnosis should be clinically useful, helping clinicians and patients understand and manage illness. Diagnosis should also provide a reliable classification for research and evidence-based treatment. The allegory of the botanist and the gardener has been used to describe diagnosis. For the botanist, a good diagnosis produces a taxonomy that is rigorous and reliable. For the gardener, it informs the way a garden is described and understood in a specific context. Clinicians need both: a ‘botanical’ type of classification to bring rigour to research and therapy, and clinical ‘gardening’, which allows for multiple perspectives and diagnostic frameworks. Clinical reasoning is a form of research with therapeutic intent. Botany and gardening represent a mixed-methods approach that can enrich diagnosis. The challenge is to integrate multiple perspectives in clinically helpful ways that help us retain both richness and rigour.

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