ICD-10-Coding of Medically Unexplained Physical Symptoms and Somatoform Disorders—A Survey With German GPs

Background: General practitioners (GPs) are reluctant to use codes that correspond to somatization syndromes.Aim: To quantify GPs' views on coding of medically unexplained physical symptoms (MUPS), somatoform disorders, and associated factors.Design and Setting: Survey with German GPs.Methods: We developed six survey items [response options “does not apply at all (1)”—“does fully apply (6)”], invited a random sample of 12.004 GPs to participate in the self-administered cross-sectional survey and analysed data using descriptive statistics and logistic regression analyses.Results: Response rate was 15.2% with N = 1,731 valid responses (54.3% female). Participants considered themselves familiar with ICD-10 criteria for somatoform disorders (M = 4.52; SD =.036) and considered adequate coding as essential prerequisite for treatment (M = 5.02; SD = 1.21). All other item means were close to the scale mean: preference for symptom or functional codes (M = 3.40; SD = 1.21), consideration of the possibility of stigmatisation (M = 3.30; SD = 1.35) and other disadvantages (M = 3.28; SD = 1.30) and coding only if psychotherapy is intended (M = 3.39; SD = 1.46). Exposure, guideline knowledge, and experience were most strongly associated with GPs' self-reported coding behaviour.Conclusions: Subjective exposure, guideline knowledge, and experience as a GP, but no sociodemographic variable being associated with GPs' subjective coding behaviour could indicate that GPs offer a relatively homogeneous approach to coding and handling of MUPS and somatoform disorders. Strengthening guideline knowledge and implementation, and practise with simulated patients could increase the subjective competence to cope with the challenge that patients with MUPS and somatoform disorders present.

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Medically unexplained physical symptoms - a multidisciplinary approach

European Psychiatry ◽

10.1016/s0924-9338(11)73277-1 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1573-1573

Author(s):

V. Pais ◽

D. Correia ◽

F. Ramalho e Silva

Keyword(s):

Multidisciplinary Approach ◽

Somatoform Disorders ◽

Physical Symptoms ◽

Medically Unexplained Physical Symptoms ◽

Daily Work ◽

Medline Search ◽

Effective Interventions ◽

Medically Unexplained ◽

Unexplained Physical Symptoms

BackgroundMedically unexplained physical symptoms (MUPS) can be defined as physical symptoms that have no currently known physical pathological cause. MUPS account for one in five new consultations in primary care and for one third of new patients when neurology consultations are considered.Patients with MUPS present significant distress and impaired function and their diagnosis is sometimes hard to establish. The classification of somatoform disorders has been found to be insufficiently useful for therapeutic and scientific purposes. Some authors suggest that new classifications should attend to clinical utility, defined as (1) the extent to which a diagnosis can help clinicians understand or conceptualize a disorder in their daily work; (2) the extent to which a diagnosis can help the clinician communicate useful information to others, including practitioners, family members, patients, and administrators; (3) the extent to which the presence of a disorder helps the clinician choose effective interventions, and (4) the extent to which a disorder can predict future clinical management needs.AimThis review aims to discuss the management of MUPS in mental health services, attending to the importance of a multidisciplinary approach.MethodsPubmed Medline search on MUPS and review of recent literature.DiscussionThe management of MUPS implies a multidisciplinary approach that can offer different solutions for different degrees of disorder severity and takes into account the perception of the patient about his own illness. New classifications of somatoform disorders that include comprehensible explanations about these symptoms could be helpful for patients and health professionals.

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Non-pharmacological interventions for somatoform disorders and medically-unexplained physical symptoms (MUPS) in adults

10.1002/14651858.cd011142 ◽

2014 ◽

Cited By ~ 56

Author(s):

Nikki Van Dessel ◽

Madelon Den Boeft ◽

Johannes C van der Wouden ◽

Maria Kleinstäuber ◽

Stephanie S Leone ◽

...

Keyword(s):

Somatoform Disorders ◽

Physical Symptoms ◽

Pharmacological Interventions ◽

Medically Unexplained Physical Symptoms ◽

Medically Unexplained ◽

Unexplained Physical Symptoms

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Does alexithymia, independent of depressive and anxiety disorders, correlate with the severity of somatic manifestations among patients with medically unexplained physical symptoms?

Journal of Experimental Psychopathology ◽

10.1177/20438087211043729 ◽

2021 ◽

Vol 12 (4) ◽

pp. 204380872110437

Author(s):

Ahmed Rady ◽

Roa Alamrawy ◽

Ismail Ramadan ◽

Mervat Abd El Raouf

Keyword(s):

Psychiatric Symptoms ◽

Tertiary Care ◽

Physical Symptoms ◽

Predictive Capacity ◽

Cross Sectional ◽

Medically Unexplained Physical Symptoms ◽

Medically Unexplained ◽

Axis I ◽

Unexplained Physical Symptoms ◽

Tas 20

Background: Medically unexplained physical symptoms (MUPS) are highly prevalent, frequently co-occurring with psychiatric symptoms such as depression, alexithymia, and anxiety. Objective: To evaluate the relation between depression, anxiety, and alexithymia and severity of somatic symptoms in patients with MUPS. Method: This is a cross-sectional study conducted on 196 patients suffering from MUPS. The patients were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. The Patient Health Questionnaire (PHQ-15), (PHQ-9), Generalized Anxiety Disorder (GAD-7), Structured Clinical Interview for DSM-IV Axis I Disorders Clinician Version (SCID-I-CV), and Toronto Alexithymia Scale (TAS-20) were employed to assess somatic severity, depression, anxiety, major mental disorders, and alexithymia in the sample of patients. Results: The results of the study indicate that GAD-7 and PHQ-9 scores had a positive correlation with PHQ-15 ( p < 0.05) in multivariate regression. In contrast, TAS-20 was not independently correlated with PHQ-15. Adding TAS-20 to GAD-7 and PHQ-9 in the equation of the regression model enhances the predictive capacity of the model ( p < 001). Conclusion: The results of the study indicate that only anxiety and depressive symptoms, but not alexithymia, were associated independently with MUPS severity.

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