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).

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.

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 in primary care

2008 ◽  
Vol 14 (6) ◽  
pp. 432-440 ◽  
Author(s):  
Else Guthrie
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Physical Abuse ◽  
Medically Unexplained Symptoms ◽  
Psychological Needs ◽  
Stepped Care ◽  
Childhood Neglect ◽  
Medically Unexplained ◽  
Primary Care Patients ◽  
Unexplained Symptoms

Adult patients with medically unexplained symptoms (somatisation) in primary care are numerous and make disproportionately high demands on health services. Most of these individuals are open to the suggestion that their illness reflects psychological needs. Empowering explanations from doctors can enable patient and doctor to work collaboratively in managing the problem and can reduce healthcare contacts. Parental medically unexplained symptoms, sexual and physical abuse in childhood and childhood neglect are associated with a greater risk of medically unexplained symptoms in adulthood. The overall prognosis for the majority of primary care patients with medically unexplained symptoms is very good. The two most common approaches to dealing with medically unexplained symptoms in primary care are stepped-care approaches and teaching general practitioners new skills to manage consultations more effectively.

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