Hospitalized Patients with Medically Unexplained Physical Symptoms: Clinical Context and Economic Costs of Healthcare Management

Abstract

Medically Unexplained Physical Symptoms (MUPS) are physical symptoms without a medical explanation. This study collected data from hospitalized patients presenting MUPS, aiming to draw a clinical and socio-demographic profile of patients with MUPS, to explore psychopathological correlations of Somatic Symptoms Disorder (SSD) diagnosis, and to estimate economic costs related to hospital management for MUPS. The cross-sectional study consisted in the evaluation of data referring to hospitalized patients admitted between 2008 and 2018 in a teaching hospital in Northern Italy. A total of 273 patients presenting MUPS have been hospitalized. The sample showed a prevalence of female, married and employed patients. The most frequent wards involved are Neurology, Internal Medicine and Short Unit Stay. The most common symptoms found are headache, pain, syncope and vertigo. There is no evidence that a history of medical disease is associated with a diagnosis of SSD. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for patients with MUPS is 475'409.73 €. The study provides the investigation of a large number of patients with MUPS and a financial estimate of related hospitalization costs.

Investigating the Psychometric Properties of the 8-Item Somatic Symptom Scale in Non-clinical Sample of Iranian People

“…Common symptoms of this disorder include various types of pain (low back pain, joint pain, headache), gastrointestinal problems (problems with digestion, vomiting, bloating), cardiovascular disorders (sweating, trembling), and chronic fatigue (Henningsen, 2018). The mean prevalence of somatic symptoms was 0.4% in the general population (Poloni et al, 2019).…”

Health Care Use and Costs of Children, Adolescents, and Young Adults With Somatic Symptom and Related Disorders

“… 35 , 36 , 37 , 38 , 39 Costs related to SSRDs are high in hospitalized adults in Italy, with mean annual per-patient costs of €47 540. 9 In both inpatients and outpatients in Holland, mean direct and indirect costs were estimated at €6815 per patient per year. 40 Others have reported $6354 (US dollars) per-patient annual health care expenditure.…”

“…Associated terms include functional disorders and, historically, medically unexplained symptoms . 4 , 9 There is overlap in the diagnostic classification of SSRDs with other conditions, such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome. 10 , 11 , 12 SSRDs are associated with considerable impairment in functioning, including school absenteeism, social isolation, reduced quality of life, unnecessary and sometimes harmful diagnostic testing, and delays in appropriate treatment and intervention for what is actually a primary mental health disorder.…”

“… 9 , 14 , 15 , 16 Some work has been done in adults to better characterize health system use and costs in these populations, but little has been done in children, adolescents, and young adults. 9 , 14 , 17 , 18 Although most patients with somatic symptoms are seen in primary care settings, 13 , 17 a proportion of individuals may be so distressed or impaired by their symptoms that they seek care in an emergency department (ED) or are hospitalized (becoming inpatients). In these latter settings, patients may present with a more severe form of the disorder, with high intensity and often unmet health care needs.…”

Does Depression Contribute to the Bladder and Bowel Complaint in Parkinson's Disease Patients?

“…While depression 5 commonly causes somatic symptom disorder (SSD), 10,11 few studies have attempted to differentiate SSD from organic autonomic failure in PD. Regarding cardiovascular system for example, Borrios et al 12 performed the Autonomic Symptom Scale (ASS) (12 items; cardiovascular, bladder, bowel, sexual, skin etc.)…”