Depression and panic: Comorbidity

1998 ◽  
Vol 13 (S2) ◽  
pp. 65s-70s ◽  
Author(s):  
DS Baldwin
Keyword(s):  
Panic Disorder ◽  
Medically Unexplained Symptoms ◽  
Epidemiological Studies ◽  
Community Settings ◽  
Recurrent Brief Depression ◽  
Cross Sectional ◽  
Increased Risk ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Use Of Medical Services

SummaryPanic disorder is a common condition. Epidemiological studies throughout the world consistently indicate that the lifetime prevalence of panic disorder (with or without agoraphobia) is between 1.5% and 3.5%. Panic disorder shows substantial comorbidity with other forms of mental illness. Major depressive disorder occurs in 50 to 65% of individuals with panic disorder and there is considerable cross-sectional and longitudinal comorbidity with recurrent brief depression and dysthymia. Phobic anxiety disorders, most notably social phobia and generalised anxiety disorder, commonly occur with panic disorder, especially in individuals with more severe agoraphobia. Approximately 35 to 50% of individuals with panic disorder in community settings also have agoraphobia. Panic disorder also shows significant comorbidity with physical illness. Compared with individuals without or with some other psychiatric diagnosis, patients with panic disorder have an increased risk of suffering from multiple medically unexplained symptoms and are associated with high use of medical services and increased mortality from both cardiovascular and cerebrovascular disease.

scholarly journals Multi-symptom illnesses, unexplained illness and Gulf War Syndrome

2006 ◽  
Vol 361 (1468) ◽  
pp. 543-551 ◽  
Author(s):  
Khalida Ismail ◽  
Glyn Lewis
Keyword(s):  
Factor Analysis ◽  
Medically Unexplained Symptoms ◽  
Epidemiological Studies ◽  
Explanatory Models ◽  
Gulf War ◽  
Gulf War Syndrome ◽  
Cross Sectional ◽  
Sociological Factors ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Explanatory models for the increased prevalence of ill health in Gulf veterans compared to those not deployed to the Gulf War 1990–1991 remain elusive. This article addresses whether multi-symptom reporting in Gulf veterans are types of medically unexplained symptoms and whether the alleged Gulf War Syndrome is best understood as a medically unexplained syndrome. A review of the epidemiological studies, overwhelmingly cross-sectional, describing ill health was conducted including those that used factor analysis to search for underlying or latent clinical constructs. The overwhelming evidence was that symptoms in Gulf veterans were either in keeping with currently defined psychiatric disorders such as depression and anxiety or were medically unexplained. The application of factor analysis methods had varied widely with a risk of over interpretation in some studies and limiting the validity of their findings. We concluded that ill health in Gulf veterans and the alleged Gulf War Syndrome is best understood within the medically unexplained symptoms and syndromes constructs. The cause of increased reporting in Gulf veterans are still not clear and requires further inquiry into the interaction between sociological factors and symptomatic distress.

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 Internal Medicine Physicians and Social media: Knowledge, Skills, and Attitudes

2020 ◽  
Vol 11 ◽  
pp. 215013272096902
Author(s):  
Mohammed Nadir Bhuiyan ◽  
Jose R. Medina-Inojosa ◽  
Ivana T. Croghan ◽  
Jasmine R. Marcelin ◽  
Karthik Ghosh ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Social Media ◽  
Medical Education ◽  
Healthcare Delivery ◽  
Medically Unexplained Symptoms ◽  
Audience Response ◽  
Cross Sectional ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Continued Medical Education

Objective Increasing adoption of social media have revolutionized communications between individuals, groups, and organizations This research study was designed to assess the knowledge, skills, and attitudes of internal medicine physicians’ awareness and engagement with social media (sometimes referred to as #SoMe) within the digital landscape of healthcare delivery. Methods An audience-response survey focused on social media “ Social media in Healthcare: Physician Survey,” was administered during the “A Systematic Approach to Medically Unexplained Symptoms” continuing medical education conference. The Conference took place between August 22, 2019 and August 24, 2019. Data was collected on August 23, 2019. A range of 103 (59.5%) to 112 (64.7%) of the total 173 attendees participated in this cross-sectional audience-response survey, depending on the questions answered. Results Most responders were between the ages of 35 and 65 years (79.6%) and female (60.2%). A majority of responders were aware of social media terminology (88.7%), and many had used it personally (46.7%), but only 12% knew how to use social media to search medical topics, 18% used it to network professionally and most (68.9%) had a distrust of social media when it came to the protection of their privacy or their patients’ privacy. Overall, about 29.6% indicated an interest in future continued medical education focused on social media (and 27.4% were neutral). Conclusions Approximately half of the responders used social media but far less engaged its platforms for professional use likely due to privacy related concerns. Distance from academic institutions, where professional social media use is more common likely, played a role in aversion. Awareness of social media’s role in healthcare has increased among physicians in practice, however their participation and knowledge of opportunities remains limited.

scholarly journals Management of medically unexplained symptoms: outcomes of a specialist liaison clinic

2014 ◽  
Vol 38 (3) ◽  
pp. 102-107 ◽  
Author(s):  
Frank Röhricht ◽  
Thomas Elanjithara
Keyword(s):  
Medically Unexplained Symptoms ◽  
Primary Diagnosis ◽  
Somatoform Disorder ◽  
Assessment Process ◽  
Service Utilisation ◽  
Cross Sectional ◽  
Care Models ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
The Impact

Aims and methodService utilisation and clinical outcomes of a newly developed specialist primary–secondary care liaison clinic for patients with medically unexplained symptoms (MUS) were evaluated in a cross-sectional and feasibility pilot study. The impact of body-oriented psychological therapy (BOPT) was explored in a small cohort of patients with an identified somatoform disorder.ResultsOf 147 consecutive referrals, 113 patients engaged with the assessment process. Of patients with MUS, 42% (n= 45) had a primary diagnosis of somatoform disorder, 36% (n= 38) depressive disorder, and depressive symptoms (even subsyndromal) mediated the effect of somatic symptoms. A marked variation of presenting complaints and service utilisation across ethnic groups was noted. A significant reduction in somatic symptom levels and service utilisation was achieved for patients undergoing BOPT.Clinical implicationsA high proportion of patients with MUS have undiagnosed and therefore untreated mental disorders. New and locally derived collaborative care models of active engagement in primary care settings are required. Patients with somatoform disorder may benefit from BOPT; this requires further evaluation in adequately powered clinical trials.

scholarly journals SOMATIZATION AND MEDICALLY UNEXPLAINED SYMPTOMS – PREVALENCE AND CORRELATES AMONG WOMEN AT NAHAQI – KPK, PAKISTAN

2019 ◽  
Vol 26 (07) ◽  
pp. 1042-1050
Author(s):  
Ali Raza ◽  
Hajira Zainab
Keyword(s):  
Medically Unexplained Symptoms ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Social Model ◽  
Anxiety And Depression ◽  
Psychiatric Evaluation ◽  
Cross Sectional ◽  
Severe Impairment ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background: Medically unexplained physical symptoms or somatization accounts for about half of the OPD visits in primary care setup. These are unclear symptoms and cannot be explained by medical or neurologic conditions. They are associated with significant stigma and over burden utilization of medical services, and results in frustration both for clinician and for the patient. The study is aimed to determine the prevalence of somatization and its association with anxiety and depression among women at Nahaqi - Charsadda and also to find out the medically unexplained symptoms among women at Nahaqi. Study Design: Comparative cross sectional study. Setting: Village Nahaqi at Nahaqi Emergency Satellite Hospital (NESH) Charsadda – KPK, Pakistan. Period: September 2016 to March, 2017. Methodology: 100 females were included in this study after informed consent. American Psychiatric Association, Level 1 Cross-cutting Symptom Measure and Level 2 – Somatic Symptoms Adult Measure containing 23 and 15 questions respectively were used. Data were collected through interviews; entered and analyzed in SPSS. The study was conducted from September 2016 to March 2017. Results: 100 out of 120 women in the age range of 15 to 65 years, mean age 37.09 ± 12.08 years responded with response rate of 83.3%. Majority were illiterate (79 %), married (81 %) women. 86 % women reported unexplained body aches and pains. The prevalence of anxiety and depression among women at Nahaqi was 50 and 57 % respectively and all items were highly significant (P < 0.000) with somatic score categories (Minimal, Low, Medium, High). The prevalence of medically unexplained symptoms was found out to be 84 %, which includes all high and medium score cases. 59 women had 5 or more mild to moderate somatic complaints, while 49 reported 5 or more severe complaints. The most frequent complaints were aches and pains (headache, backache and musculo-skeletal aches and pains) followed by lack of energy, general asthenia. Conclusion: Nearly every second women was noted to have unexplained aches and pains, which shows that somatization is a frequent complaint in primary health settings. Majority cases were milder, however, patients showing severe impairment or more complaints they need particular attention. Although MUS result in extra stress on health services utilization in women visiting a rural health facility – Nahaqi; those with serious impairment shall be referred for psychiatric evaluation. A comprehensive medical, psycho-social model that involves community shall be formulated to address this issue.

scholarly journals Preventing somatization

2004 ◽  
Vol 34 (2) ◽  
pp. 195-198 ◽  
Author(s):  
MATTHEW HOTOPF
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Psychiatric Disorder ◽  
Secondary Care ◽  
Medically Unexplained Symptoms ◽  
Cross Sectional ◽  
Frequent Attenders ◽  
Medically Unexplained ◽  
Significant Disability ◽  
Unexplained Symptoms

Countless cross-sectional surveys of primary and secondary care have demonstrated the ubiquitous nature of medically unexplained symptoms. If grouping diverse symptoms under one heading is appropriate, they account for over half of all new presentations in secondary medical care (Nimnuan et al. 2001a) and a sizeable proportion of ‘frequent attenders’ in secondary care have predominantly medically unexplained symptoms (Fink, 1992a; Reid et al. 2002). Such symptoms are costly, persistent, and associated with significant disability and psychiatric disorder (Reid et al. 2001, 2003), but are generally ignored by mental health services (Bass et al. 2001).

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