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.

Learning to provide patient-centered care with patients with medically unexplained symptoms: a grounded theory study in Australian general practice.

2015 ◽  
Vol 4 (3) ◽  
pp. 173-179
Author(s):  
Louise Stone ◽  
Jill Gordon
Keyword(s):  
General Practice ◽  
Grounded Theory ◽  
Medically Unexplained Symptoms ◽  
Patient Centered Care ◽  
Physical Symptoms ◽  
Patient Centered ◽  
Grounded Theory Study ◽  
Centered Care ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background Culture shapes the way illness is experienced and disease is understood. Patients with medically unexplained symptoms describe feeling their suffering is not valued because they lack a “legitimate” diagnosis. Doctors also describe feeling frustrated with these patients. This is particularly problematic for young general practitioners (GPs) who lack experience in managing patients with medically unexplained symptoms in primary care settings.Objectives To explore how general practice supervisors help registrars to provide patient-centered care for patients with medically unexplained. Methods A constructivist grounded theory study was undertaken with 24 general practice registrars and supervisors from Australian GP training practices in urban, rural and remote environments. Participants were asked to describe patients with mixed emotional and physical symptoms without an obvious medical diagnosis. Results Registrars came from hospital posts into general practice equipped with skills to diagnose and manage organic disease but lacked a framework for assessing and managing patients with medically unexplained symptoms. They described feelings of helplessness, frustration and sometimes hostility. Because these feelings were inconsistent with their expressed value systems, they were uncomfortable and confronting. The registrars valued interactions that helped them explore this area. Conclusions In hospital practice, biomedical language and explanations predominate, but in general practice patients bring different explanatory illness models to the consultation, using their own language, beliefs and cultural frameworks. Medically unexplained symptoms occupy a contested space in both the social and medical worlds of the doctor and patient. Negative feelings and a lack of diagnostic language and frameworks may prevent registrars from providing patient-centered care.

Anthrax Exposure, Belief in Exposure, and Postanthrax Symptoms Among Survivors of a Bioterrorist Attack on Capitol Hill

2018 ◽  
Vol 13 (03) ◽  
pp. 555-560
Author(s):  
Stephanie Chiao ◽  
Howard Kipen ◽  
William K. Hallman ◽  
David E. Pollio ◽  
Carol S. North
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Symptoms ◽  
Care Utilization ◽  
Physical Injury ◽  
Multivariate Models ◽  
Diagnostic Interviews ◽  
Capitol Hill ◽  
High Incidence ◽  
Medically Unexplained ◽  
Unexplained Symptoms

ABSTRACTBackgroundFollowing chemical, biological, radiological, and nuclear disasters, medically unexplained symptoms have been observed among unexposed persons.ObjectivesThis study examined belief in exposure in relation to postdisaster symptoms in a volunteer sample of 137 congressional workers after the 2001 anthrax attacks on Capitol Hill.MethodsPostdisaster symptoms, belief in exposure, and actual exposure status were obtained through structured diagnostic interviews and self-reported presence in offices officially designated as exposed through environmental sampling. Multivariate models were tested for associations of number of postdisaster symptoms with exposure and belief in exposure, controlling for sex and use of antibiotics.ResultsThe sample was divided into 3 main subgroups: exposed, 41%; unexposed but believed they were exposed, 17%; and unexposed and did not believe that they were exposed, 42%. Nearly two-thirds (64%) of the volunteers reported experiencing symptoms after the anthrax attacks. Belief in anthrax exposure was significantly associated with the number of ear/nose/throat, musculoskeletal, and all physical symptoms. No significant associations were found between anthrax exposure and the number of postdisaster symptoms.ConclusionsGiven the high incidence of these symptoms, these data suggest that even in the absence of physical injury or illness, there may be surges in health care utilization. (Disaster Med Public Health Preparedness.2019;13:555-560)

scholarly journals Depression and anxiety in a community sample with epilepsy in Brazil

2011 ◽  
Vol 69 (2b) ◽  
pp. 342-348 ◽  
Author(s):  
S Stefanello ◽  
L Marín-Léon ◽  
P T Fernandes ◽  
L M Li ◽  
N J Botega
Keyword(s):  
Suicide Attempts ◽  
Community Sample ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Psychiatric Evaluation ◽  
Depression And Anxiety ◽  
Community Based ◽  
Cross Sectional ◽  
The Social

OBJECTIVE: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy. METHOD: A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without. RESULTS: The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4). CONCLUSION: The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy.

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.

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 Post-vasectomy depression: a case report and literature review

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Subahani Shaik ◽  
Ravi Philip Rajkumar
Keyword(s):  
Panic Attack ◽  
Medically Unexplained Symptoms ◽  
Marital Relationships ◽  
Anxiety And Depression ◽  
Safe Procedure ◽  
Poor Knowledge ◽  
Post Operative Pain ◽  
Prevention And Treatment ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure – a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient’s current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined.

A cross-sectional study to understand the pervasiveness of psychiatric features among tinnitus and vertigo patients

2021 ◽  
Vol 71 (10) ◽  
pp. 2340-2343
Author(s):  
Ammar Ahmed ◽  
Muhammad Aqeel ◽  
Naeem Aslam ◽  
Bashir Ahmed
Keyword(s):  
Psychiatric Symptoms ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Psychiatric Evaluation ◽  
Sectional Study ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Ethical Approval ◽  
As Stress ◽  
Psychiatric Problems

Objective: To identify the psychiatric features among patients having tinnitus and vertigo symptoms due to vestibulocochlear disturbances. Methods: A cross-sectional study was conducted on Vestibulocochlear disorder Patients aged 18 Years and above, having chief symptoms of vertigo and tinnitus for the past 3 months. Patients having any cardiac linked disease and experiencing side effects of some medicines were excluded from the study. Present study spanned from May to September, 2019 at Hearts International Hospital, Rawalpindi and Hearing and Balance clinic, Rawalpindi in collaboration with the Foundation University, Islamabad. Ethical approval was obtained from the ethics committee of the Psychology department of Foundation University, Islamabad. Psychiatric evaluation was conducted by incorporating Tinnitus Handicap Inventory (THI), Dizziness Handicap Inventory (DHI) and Depression, Anxiety, Stress Scale (DASS). Audiological evaluations were carried out to gauge the severity of symptoms. Results: Of the 202 subjects, 60 were female (30%) and 142 were male (70%), fulfilling the inclusion criterion. It was found that patients experiencing vertigo and tinnitus symptoms had a strong tendency to develop psychiatric problems such as stress, anxiety and depression. Significant differences were noted among male and female patients regarding the representation of psychiatric symptoms. Conclusion: Various factors contribute and interfere in the psychological process that further contribute and aggravate the severity and symptoms of tinnitus and vertigo. Patients experiencing symptoms like tinnitus and vertigo in this domain tend to have a deviant psychological profile that is analogous with other chronic diseases. Continuous...

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