Frequent attenders in secondary care: a 3-year follow-up study of patients with medically unexplained symptoms

2003 ◽  
Vol 33 (3) ◽  
pp. 519-524 ◽  
Author(s):  
S. REID ◽  
T. CRAYFORD ◽  
A. PATEL ◽  
S. WESSELY ◽  
M. HOTOPF
Keyword(s):  
Functional Impairment ◽  
Secondary Care ◽  
Service Use ◽  
Psychiatric Morbidity ◽  
Medically Unexplained Symptoms ◽  
Follow Up Study ◽  
Frequent Attenders ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background. There are few longitudinal studies of patients with medically unexplained symptoms. The aim of this study was to investigate outcome in frequent attenders in secondary care who present repeatedly with medically unexplained symptoms.Method. Forty-eight patients presenting with medically unexplained symptoms, from a sample of 61, participated in a 3-year follow-up study. Psychiatric morbidity, functional impairment and use of services were evaluated.Results. At follow-up there was a high prevalence of psychiatric morbidity with 69% having at least one psychiatric diagnosis. The sample continued to be high users of a range of health services and substantial functional impairment was reported.Conclusion. In this group of frequent attenders with medically unexplained symptoms outcome as measured by psychiatric morbidity, service use and functional impairment remained poor after 3 years.

scholarly journals Frequent attenders with medically unexplained symptoms: service use and costs in secondary care

2002 ◽  
Vol 180 (3) ◽  
pp. 248-253 ◽  
Author(s):  
Steven Reid ◽  
Simon Wessely ◽  
Tim Crayford ◽  
Matthew Hotopf
Keyword(s):  
Health Care ◽  
Secondary Care ◽  
Service Use ◽  
Medically Unexplained Symptoms ◽  
Health Care Use ◽  
Health Care Resources ◽  
Care Services ◽  
Frequent Attenders ◽  
Medically Unexplained ◽  
Unexplained Symptoms

BackgroundFrequent attenders in medical settings account for a disproportionate amount of health-care resources. Little is known about service use and costs of secondary care in those frequent attenders presenting with medically unexplained symptoms.AimsTo compare health-care use and costs of patients with medically unexplained symptoms with other frequent attenders in secondary care.MethodIn a sample of 400 frequent attenders of secondary care services, those presenting with medically unexplained symptoms were identified by a review of medical records. Their use of health-care resources was compared with that of other frequent attenders.ResultsOf the frequent attenders 17% had at least two medically unexplained consultation episodes. These patients had a greater number of referrals to secondary care and were more likely to undergo particular investigations.ConclusionsFrequent attenders with medically unexplained symptoms account for levels of service use and expenditure that are comparable with other frequent attenders, but the use and cost of medical investigations in this group are significantly greater.

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).

Liaison Psychiatry and Organic Illness

2014 ◽  
Author(s):  
Andrew Horton ◽  
Mark Broadhurst
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Symptoms ◽  
Mental Illnesses ◽  
Working Relationships ◽  
Liaison Psychiatry ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
The Uk

Liaison psychiatry is a subspecialty of psychiatry which involves the diag­nosis, treatment, and management of psychiatric illness in patients who have physical illnesses or present with physical symptoms. There is considerable overlap between psychiatric and medical condi­tions which requires close working relationships with medical colleagues. Liaison psychiatry is a fascinating area where the range of psychiatric presentations is wide, every case is different, and there is opportunity to keep up to date with medicine as it evolves. Within the UK there are different models practiced in different areas, ranging from assessment and signposting services to services with provi­sion for long-term outpatient follow-up. There is increasing interest in the provision of liaison services in primary care because of the challenges faced by GPs in treating patients with medically unexplained symptoms. Another driver is the hugely increased morbidity and mortality rates seen in patients with co-morbid physical and mental illnesses who receive the majority of their treatment in secondary care.

Neuroticism, alexithymia, negative affect and positive affect as predictors of medically unexplained symptoms in primary care

2002 ◽  
Vol 14 (4) ◽  
pp. 181-185 ◽  
Author(s):  
V. De Gucht
Keyword(s):  
Primary Care ◽  
Negative Affect ◽  
Positive Affect ◽  
Personality Traits ◽  
Affective State ◽  
Medically Unexplained Symptoms ◽  
Positive And Negative Affect ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background:Somatization has been defined in a number of ways. Despite their differences, these definitions have one element in common, namely the presence of somatic symptoms that cannot be explained (adequately) by organic findings.Objective:The primary objectives of the dissertation were to gain a better insight into the concept of somatization, and to study (prospectively) the relationship between neuroticism and alexithymia, two personality traits that have been shown to be related to somatization, the affective state dimensions positive and negative affect (or psychological distress) and medically unexplained symptoms.Method:A selective review was conducted regarding conceptual and methodological issues related to somatization. A total number of 318 patients, presenting to their primary care physician with medically unexplained symptoms, participated in the prospective study. Both at baseline and at 6-month follow-up a number of measures were filled out with respect to somatization, neuroticism, alexithymia, negative and positive affect, anxiety and depression.Results:The concept of somatization was clarified, thereby making use of the distinction between presenting and functional somatization. The personality traits neuroticism and alexithymia were found to have an indirect influence on symptom reports. Both the cross-sectional and follow-up data pointed to the importance of positive and negative affect as determinants of (changes in) number of symptoms (over time). Negative affect, together with the alexithymia dimension measuring difficulty identifying feelings, predicted symptom persistence.Conclusions:The theoretical as well as therapeutic implications of the present paper may give an impetus to new research in the domain of somatization.

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