A Follow-up Study of Patients with Medically Unexplained Symptoms Referred to a Liaison Psychiatry Service

2011 ◽  
Vol 41 (3) ◽  
pp. 217-227 ◽  
Author(s):  
Simon Hatcher ◽  
Kylie Gilmore ◽  
Katherine Pinchen
Keyword(s):  
Medically Unexplained Symptoms ◽  
Liaison Psychiatry ◽  
Follow Up Study ◽  
Medically Unexplained ◽  
Unexplained Symptoms

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.

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.

scholarly journals New models of care: a liaison psychiatry service for medically unexplained symptoms and frequent attenders in primary care

2017 ◽  
Vol 41 (6) ◽  
pp. 340-344 ◽  
Author(s):  
Janine Bestall ◽  
Najma Siddiqi ◽  
Suzanne Heywood-Everett ◽  
Charlotte Freeman ◽  
Paul Carder ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Synthesis ◽  
Medically Unexplained Symptoms ◽  
Cost Savings ◽  
Models Of Care ◽  
Liaison Psychiatry ◽  
Long Term Conditions ◽  
Early Results ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Aims and methodThis paper describes the process of setting up and the early results from a new liaison psychiatry service in primary care for people identified as frequent general practice attenders with long-term conditions or medically unexplained symptoms. Using a rapid evidence synthesis, we identified existing service models, mechanisms to identify and refer patients, and outcomes for the service. Considering this evidence, with local contingencies we defined options and resources. We agreed a model to set up a service in three diverse general practices. An evaluation explored the feasibility of the service and of collecting data for clinical, service and economic outcomes.ResultsHigh levels of patient and staff satisfaction, and reductions in the utilisation of primary and secondary healthcare, with associated cost savings are reported.Clinical implicationsA multidisciplinary liaison psychiatry service integrated in primary care is feasible and may be evaluated using routinely collected data.

Liaison psychiatry

2019 ◽  
pp. 839-880
Author(s):  
David Semple ◽  
Roger Smyth
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Illness ◽  
Anxiety Symptoms ◽  
Differential Diagnoses ◽  
Psychotic Symptoms ◽  
Liaison Psychiatry ◽  
Medically Unexplained ◽  
Medical Population ◽  
Self Harm ◽  
Unexplained Symptoms

This chapter concerns liaison psychiatry and the assessment and management of psychiatric and psychological illnesses in the general medical population. It covers the 12 most common referral types, assessment of depressive and anxiety symptoms, psychotic symptoms and confusion, depression in physical illness, delirium, and management after self-harm. Focusing on capacity and consent, as well as differential diagnoses and potential management principles for medically unexplained symptoms, it covers the basis of working as a psychiatrist in a hospital.

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.

scholarly journals A CBT-based approach to medically unexplained symptoms

2009 ◽  
Vol 15 (2) ◽  
pp. 146-151 ◽  
Author(s):  
Catriona Kent ◽  
Graham McMillan
Keyword(s):  
Medically Unexplained Symptoms ◽  
Behavioural Therapy ◽  
Liaison Psychiatry ◽  
General Psychiatry ◽  
Cognitive Behavioural ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
The Common ◽  
Common Problems ◽  
Set Up

SummaryThis article discusses a cognitive–behavioural therapy (CBT) approach to the treatment of medically unexplained symptoms that is based on the ‘five areas’ model of CBT. We describe a typical course of therapy and some of the common problems encountered during treatment. Emphasis is placed on the practical management of these conditions, and the focus is on symptoms as opposed to cause. We believe that this approach is widely applicable and could be used in a large range of settings to tackle these debilitating conditions. In writing this article we intended to provide an overview of patients with medically unexplained symptoms. The article would be of interest to staff within liaison psychiatry departments looking to set up a medically unexplained symptoms service and general psychiatry teams who may have contact with patients presenting with somatic symptoms. Psychiatric teams without access to a liaison department may also find this article interesting.

Liaison psychiatry

2013 ◽  
pp. 775-818
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Illness ◽  
Anxiety Symptoms ◽  
Psychotic Symptoms ◽  
Acute Confusional State ◽  
Liaison Psychiatry ◽  
Clinical Presentations ◽  
Medically Unexplained ◽  
Self Harm ◽  
Unexplained Symptoms

Introduction Working in the general hospital Assessment of depressive and anxiety symptoms Assessment of psychotic symptoms and confusion Assessment after self-harm Management after self-harm Depression in physical illness Acute confusional state (delirium) Capacity and consent Medically unexplained symptoms 1: introduction Medically unexplained symptoms 2: clinical presentations...

scholarly journals Medically Unexplained Symptoms (MUS): Faults and Implications

2019 ◽  
Vol 16 (7) ◽  
pp. 1247 ◽  
Author(s):  
Michiel Tack
Keyword(s):  
Medically Unexplained Symptoms ◽  
Health Condition ◽  
Negative Consequences ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Underlying Pathology ◽  
Long Term Studies

The classification of medically unexplained symptoms (MUS) could have negative consequences for patients with functional somatic syndromes (FSS). By grouping related but distinct syndromes into one label, the MUS classification fails to inform clinicians about their patients’ health condition. In research settings, the MUS classification makes patient samples more heterogeneous, obstructing research into the underlying pathology of FSS. Long-term studies have shown that MUS are often appraised as medically explained symptoms at follow-up and vice versa, raising doubts about the reliability of this distinction.

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