Medically unexplained symptoms in an urban general medicine practice

Area of Science:

• Primary Care Medicine
• Psychiatry
• Health Services Research

Background:

• Multiple medically unexplained symptoms (MMUS) represent a significant challenge in primary care settings.
• Understanding the prevalence and characteristics of MMUS in diverse patient populations is crucial for effective management.

Purpose of the Study:

• To investigate the prevalence of multiple medically unexplained symptoms (MMUS) identified by primary care physicians (PCPs).
• To characterize the demographic and clinical features of patients with MMUS in an urban, low-income primary care practice.

Main Methods:

• A systematic sample of 172 patients from a university-affiliated urban primary care practice was analyzed.
• Patients were assessed for the presence of MMUS as identified by PCPs.
• Demographic data, psychiatric diagnoses, and functional impairment were evaluated.

Main Results:

• Patients with MMUS were older, more frequently female, and less likely to be married or partnered.
• The prevalence of MMUS in this urban, low-income clinic was comparable to that in more affluent settings.
• Patients with MMUS exhibited significantly higher rates of current psychiatric disorders (over twice the rate) and anxiety disorders (almost two-and-a-half times the rate), along with greater functional impairment.

Conclusions:

• Multiple medically unexplained symptoms (MMUS) are prevalent in urban primary care, including in low-income populations.
• Patients with MMUS present with distinct demographic and clinical profiles, including higher psychiatric comorbidity and functional impairment.
• Primary care physicians (PCPs) should routinely screen patients with MMUS for common and treatable psychiatric conditions to improve patient outcomes.