Investigation of Mental Health in Patients with Medically Unexplained Physical Symptoms
-
Frough Riahi
,
Maryam Izadi-mazidi
,
Niloufar Khajeddin
,
Shahriar Nasirzadeh
,
Fatemeh Shafieian
,
Ammar Helalinasab
,
Mozhgan Deilamani
Abstract
Objective: Medically unexplained symptoms are physical symptoms, which cannot be explained by organic causes. This study aimed to investigate mental health in patients with medically unexplained physical symptoms.
Method: One hundred outpatients who were admitted to the Electro Diagnosis Clinic of Imam Khomeini hospital, Ahvaz/Iran, participated in this study. Data were collected using physical examination, paraclinical examinations, and SCL-90-R, and analyzed through multivariate analysis of variance (MANOVA), Chi-square test and Fisher’s exact test.
Results: The findings revealed significant differences between clients with medically explained and unexplained symptoms in obsessive compulsive and somatization (p<0.05). Differences in depression, anxiety, phobia, psychosis, aggression and paranoia were not significant (p>0.05).
Conclusion: The present study suggested an association between some psychological problems and somatic symptoms. Therefore, screening for psychological impairments can improve clinical outcomes.
Hansen HS, Rosendal M, Fink P, Bech Risor M. The General Practitioner’s Consultation Approaches to Medically Unexplained Symptoms: A Qualitative Study. Fam Med 2013; 2: 1-7.
de C Williams AC, Cella M, Cella M. Medically unexplained symptoms and pain: misunderstanding and myth. Curr Opin Support Palliat Care 2012; 6: 201-206.
Ravenzwaaij J van, olde Hartman TC, Ravesteijn H van, Eveleigh R, Rijswijk E van, Lucassen PLBJ. Explanatory models of medically unexplained symptoms: a qualitative analysis of the literature. Ment Health Fam Med 2010; 7: 223–231.
Creed F, Henningsen P, Fink P. Medically Unexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services. 1st Ed. New York: Cambridge University Press; 2011.
Duddu V, Husain N, Dickens C. Medically unexplained presentations and quality of life: a study of a predominantly South Asian primary care population in England. J Psychosom Res 2008; 65: 311-317.
Dirkzwager, Anja JE, and Peter FM Verhaak. Patients with persistent medically unexplained symptoms in general practice: characteristics and quality of care. BMC Fam Pract 2007; 8: 33.
Edwards TM, Stern A, Clarke DD, Ivbijaro G, Kasney LM. The treatment of patients with medically unexplained symptoms in primary care: a review of the literature. Ment Health Fam Med 2010; 7: 209–221.
Reid S, Wessely S, Cray ford T, Hotopf M. Frequent attenders with medically unexplained symptoms: service use and costs in secondary care. B J Psych 2002; 180: 248-253.
Katon W, Sullivan M, Walker E. Medical Symptoms without Identified Pathology: Relationship to Psychiatric Disorders, Childhood and Adult Trauma, and Personality Traits. Ann. Intern. Med 2001; 134: 917-925.
Lowe B, Spitzer RL, Williams JBW, Mussell M, Schellberg D, Kroenke K. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. Gen Hosp Psychiatry 2008; 30: 191-199.
De Waal MWM, Arnold IA, Eekhof JAH, Van Hemert AM. Somatoform disorders in general practice: prevalence, functional impairment and comorbidity with anxiety and depressive disorders. B J Psych 2004; 184: 470-476.
Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry 2005; 62: 903- 910.
Garcia-Campayo J, Alda M, Sobradiel N, Olivan B, Pascual A. Personality disorders in somatization disorder patients: a controlled study in Spain. J Psychosom Res 2007; 62: 675-680.
Maina G, Albert U, Gandolfo S, Vitalucci A, Bogetto F. Personality disorders in patient’s with burning mouth syndrome. J PERS DISORD 2005; 19: 84-93.
Noyes R, Langbehn DR, Happel RL, Stout LR, Muller BA, Longley SL. Personality dysfunction among somatizing patients. Psychosomatics 2001; 42: 320-329.
Henderson M, Tannock C. Objective assessment of personality disorder in chronic fatigue syndrome. J Psychosom Res 2004; 56: 251-254.
Dammen T, Ekeberg O, Arnesen H, Friis S. Personality profiles in patients referred for chest pain: investigation with emphasis on panic disorder patients. Psychosomatics 2000; 41: 269-276.
Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry 2005; 62: 903- 910.
Zarghami M, Shayesteh Âzar M, Khalilian A, Âghabarari F, Ârjmand A. Psychological aspects of low back pain in patients with radiculopathy and without any clinical signs. J Mazandaran Univ Med Sci 2006; 16: 57-64 .
Khajehmougahi N, Ahmadi Q. Psychological problems in low back pain patients. Pak J Med Sci 2008; 24: 447-451.
Morriss R.K, Ahmed M, Wearden A.J, Mullis R, Strickland P, Appleby L, et al. The role of depression in pain, psychophysiological syndromes and medically unexplained symptoms associated with chronic fatigue syndrome. J Affect Disord 1999; 55: 143–148.
Creed F. Should general psychiatry ignores somatization and hypochondriasis? World Psychiatry 2006; 5: 146–50.
Henningsen P, Zimmermann T, Sattel H. Medically unexplained physical symptoms, anxiety, and depression: a meta-analytic review. Psychosom Med 2003; 65: 528-33.
Firat S, Somer Diler R, Avci A, Seydaoglu G. Comparison of Psychopathology in the Mothers of Autistic and Mentally Retarded Children. KAMS 2002; 17: 679-85.
Carson AJ, Ringbauer B, Stone J, McKenzie L, Warlow C, Sharpe M. Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry 2000; 68: 207-210.
Henningsen PZ. Medically unexplained physical symptoms, anxiety, and depression: a meta- analytic review. Psychosom Med 2003; 65: 528–533.
Stone J, Carson a, Duncan R, Coleman R, Roberts R, Warlow C, et al. Symptoms 'unexplained by organic disease' in 1144 new neurology out-patients: how often does the diagnosis change at follow-up? Brain 2009; 132: 2878-2888.
Burton C, McGorm K, Weller D and Sharpe M. Depression and anxiety in patients repeatedly referred to secondary care with medically unexplained symptoms: a case-control study. Sharpe. Psychol Med 2011; 41: 555-563.
Maiden N L, Hurst N P, Lochhead A, Carson A J, Sharpe M. Medically un explained symptoms in patients referred to a specialist rheumatology service: prevalence and associations. Rheumatology 2002; 42: 108-112.
Verhaak PFM, Meijer SA, Visser AP and Wolters G. Persistent presentation of medically unexplained symptoms in general practice. J Fam Pract 2006; 23: 414–420.
Hilderink P H, Collard R, Rosmalen JGM, Oude Voshaar RC. Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups: A systematic review. Ageing Res Rev 2013; 12: 151–156.
Rolfe A. Medically Unexplained Symptoms. Innov Ai T 2011; 4: 250-256.
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| Issue | Vol 11 No 1 (2016) | |
| Section | Original Article(s) | |
| Keywords | ||
| Medically Unexplained Symptom Mental health Electro Diagnosis | ||
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