Medically Unexplained Symptoms

Isaac, Margaret; Paauw, Douglas S.

doi:10.1016/j.mcna.2014.01.013

Cited by 32 publications

(33 citation statements)

References 50 publications

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“…This implies that patients have had medically unsolved disorders for a long time, have continued searching for a diagnosis and treatment, or are being erroneously diagnosed and managed 49 . One possible explanation is that dorsal/lumbar pain is a frequent symptom occurring in various conditions, and is one of the most common symptoms attributable to 6 The 1 2, 3, 6a), 14a), 14b), 15, 18, 20, 22 low STROBE: Strengthening The Reporting of OBservational studies in Epidemiology.…”

Section: Discussionmentioning

confidence: 99%

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Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

Jovaní

Blasco-Blasco²,

Ruiz-Cantero³

et al. 2016

J Rheumatol

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Objective.To identify empirical evidence of diagnostic delay in spondyloarthritis (SpA), determine whether sex-related differences persist, and conduct an analysis from that perspective of the possible causes, including the influence of quality research, in this group of inflammatory rheumatic diseases.Methods.A systematic review was done of delay in diagnosis of SpA in MEDLINE and EMBASE and other sources. Study quality was determined in line with the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement. A metaanalysis of 13 papers reporting sex-disaggregated data was performed to evaluate sex-related differences in diagnostic delay. The global effect of diagnostic delay by sex was calculated using means difference (D) through a fixed effects model.Results.The review included 23,883 patients (32.3% women) from 42 papers. No significant differences between the sexes were detected for symptoms at disease onset or during evolution. However, the mean for delay in diagnosis of SpA showed sex-related differences, being 8.8 years (7.4–10.1) for women and 6.5 (5.6–7.4) for men (p = 0.01). Only 40% of papers had high quality. A metaanalysis included 12,073 participants (31.2% women). The mean global effect was D = 0.6 years (0.31–0.89), indicating that men were diagnosed 0.6 year (7 months) before women.Conclusion.Delay in diagnosis of SpA persists, and is longer in women than in men. There are no significant sex-related differences in symptoms that could explain sex-related differences in diagnostic delay. Methodological and possible publication bias could result in sex-biased medical practice.

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Section: Discussionmentioning

confidence: 99%

“…Consequently, the disease is not suspected in women, and a wrong diagnosis or "non-specific symptoms and signs" is given in healthcare records 49 .…”

Section: Journal Of Rheumatologymentioning

confidence: 99%

Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

Jovaní

Blasco-Blasco²,

Ruiz-Cantero³

et al. 2016

J Rheumatol

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“…The term medically unexplained symptoms (MUS) does not have a perspicuous definition, but is generally accepted to include those symptoms that evade the search for a medical cause (1,2). The condition is very commonly encountered in general clinical practice, and may lead to a battery of investigations exploring the genesis of symptoms (3).…”

Section: Introductionmentioning

confidence: 99%

Pathways to Care for Medically Unexplained Symptoms at a Specialty Psychosomatic Clinic in South India in 2014

Menon

Vivek

Sarkar

2016

Iran J Psychiatry Behav Sci

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Background: A growing body of evidence suggests that patients with medically unexplained symptoms (MUS) tend to delay help seeking behaviours. Objectives: The aim of this study was to explore the pathway to care for patients with MUS at a specialty psychosomatic clinic. Materials and Methods:The clinic caters to patients with MUS referred from other departments or directly seeking treatment. After detailed assessment, diagnosis was made as per ICD 10 clinical descriptions, diagnostic guidelines, and management plan. The pathway of care for patients registered in this clinic was assessed, using a structured questionnaire. Results: Pathway-of-care information was available for 49 out of the 53 patients (92.5% of the sample) registered in the first 8 months of the clinic. The median age of the participants was 36 years, of them, 25 (51.0%) were female, 40 (81.6%) married, and 32 (65.3%) belonged to nuclear family. Thirty-three patients (67.3%) visited general practitioners, 13 (26.5%) had visited traditional practitioners and faith healers, 48 (98.0%) had made visits to specialists/ tertiary care centers, and nine (18.4%) had consulted psychiatrists before being referred to our center. The first point of contact was the general practitioner in the majority of the cases (55.1%). Patients had waited for a mean of 21.73 (± 36.55) months and taken 5.53 (± 3.86) consultations before referring to our clinic. Conclusions: Patients with medically unexplained somatic symptoms may undertake considerable number of consultations before being referred to psychiatric treatment services. This signifies the need to train more doctors, particularly general practitioners, to empower them to recognize and manage unexplained medical symptoms.

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“…Typical examples are "this is a clinically, conceptually, and emotionally difficult area." [41] (p. 336), "MUS are challenging to treat and can be frustrating for primary care physicians to address and manage" [5] (p. 664), and "there are a number of characteristic features of MUS that make them particularly difficult to handle scientifically." [9] (p. 2).…”

Section: Introductionmentioning

confidence: 99%

What's ‘difficult’? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms

Maatz¹,

Wainwright

Russell

et al. 2016

Journal of Psychosomatic Research

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Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. AbstractBackground The term 'difficult' is pervasively used in relation to medically unexplained symptoms (MUS) and patients with MUS. This article scrutinises the use of the term by analysing interview data from a study of secondary care specialists' experiences with and attitudes towards patients suffering from MUS.

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Medically Unexplained Symptoms

Cited by 32 publications

References 50 publications

Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

Pathways to Care for Medically Unexplained Symptoms at a Specialty Psychosomatic Clinic in South India in 2014

What's ‘difficult’? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms

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