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Related Experiment Videos

Medically unexplained symptoms in primary care

W J Katon1, E A Walker

  • 1Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, Seattle 98195-6560, USA.

The Journal of Clinical Psychiatry
|January 9, 1999
PubMed
Summary
This summary is machine-generated.

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Many common physical symptoms lack organic causes, leading to frustration and high healthcare costs. Psychological distress, including anxiety and depression, correlates with medically unexplained symptoms and functional impairment.

Area of Science:

  • Primary Care Medicine
  • Psychosomatic Medicine
  • Clinical Psychology

Background:

  • Common physical symptoms account for nearly half of primary care visits.
  • A significant majority of these symptoms (85-90%) are not linked to organic illness within a year.
  • Medically unexplained symptoms (MUS) pose challenges for physicians and lead to disproportionate healthcare utilization and costs.

Purpose of the Study:

  • To review the association between psychological distress and seeking medical care for common physical symptoms.
  • To present evidence linking lifetime accumulation of MUS to psychological factors.
  • To recommend validated scales for assessing somatization and hypochondriasis in clinical practice.

Main Methods:

  • Literature review examining the relationship between psychological distress and symptom presentation.

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  • Analysis of evidence correlating MUS with lifetime psychiatric diagnoses, personality traits, and functional impairment.
  • Identification and recommendation of psychometric assessment tools.

    • Main Results:

    • An increasing number of medically unexplained symptoms over a lifetime shows a linear correlation with the number of anxiety and depressive disorders.
    • Higher scores on the personality dimension of neuroticism are associated with a greater number of MUS.
    • The degree of functional impairment is also linearly related to the accumulation of MUS.

    Conclusions:

    • Psychological distress is a significant factor in the presentation of common physical symptoms in primary care.
    • Lifetime history of anxiety, depression, neuroticism, and functional impairment are key indicators for patients with MUS.
    • Validated scales for somatization and hypochondriasis can aid in the assessment and management of patients with MUS in primary and specialty care settings.