TY - JOUR
KW - Adult
KW - Comorbidity
KW - Family Practice
KW - Female
KW - Humans
KW - Male
KW - Mental Disorders/diagnosis
KW - Middle Aged
KW - Predictive Value of Tests
KW - Primary Health Care
KW - Psychiatric Status Rating Scales
KW - Retrospective Studies
KW - Somatoform Disorders/diagnosis
AU - J. M. Aiarzaguena
AU - G. Grandes
AU - A. Salazar
AU - I. Gaminde
AU - A. Sanchez
A1 - 
AB - OBJECTIVE: To describe the complexity of somatizing patients' symptomatology and the difficulties involved in the diagnostic process. DESIGN. Cross-sectional study of patients with medically unexplained symptoms. SETTING: Basque Health Service primary care centres in Bizkaia, Spain. SUBJECTS: The study comprised 156 patients selected at random from a list of 468 patients who had presented, over the course of their lives, six or more medically unexplained somatic symptoms for females and four or more for males, identified retrospectively by their practitioners. MAIN OUTCOME MEASURES: Physicians interviewed these patients using the somatoform symptoms section of the Composite International Diagnostic Interview (CIDI), and the Primary Care Evaluation of Mental Disorders (PRIME-MD). The Medical Outcomes Survey Short Form 36 (SF-36) was filled in at home. Organic diseases whose diagnosis was established during the previous year were included in the study by consulting patients' medical records. RESULTS: Patients were found to have a median of three medically explained and 12 medically unexplained symptoms. Mental disorders were found in 83% of cases, associated with other morbidity categories in 78%. The predictive value of symptoms was lower than 26% for diagnosing broad disease categories. CONCLUSIONS: These results depict an extremely difficult scenario for dichotomous diagnostic strategies aimed at classifying patients' symptoms as either organic or functional. Rather than struggling to choose one of these hypotheses, it is suggested that both of them should always be addressed concurrently.
BT - Scandinavian journal of primary health care
C5 - Medically Unexplained Symptoms
CP - 2
CY - Norway
IS - 2
JF - Scandinavian journal of primary health care
N2 - OBJECTIVE: To describe the complexity of somatizing patients' symptomatology and the difficulties involved in the diagnostic process. DESIGN. Cross-sectional study of patients with medically unexplained symptoms. SETTING: Basque Health Service primary care centres in Bizkaia, Spain. SUBJECTS: The study comprised 156 patients selected at random from a list of 468 patients who had presented, over the course of their lives, six or more medically unexplained somatic symptoms for females and four or more for males, identified retrospectively by their practitioners. MAIN OUTCOME MEASURES: Physicians interviewed these patients using the somatoform symptoms section of the Composite International Diagnostic Interview (CIDI), and the Primary Care Evaluation of Mental Disorders (PRIME-MD). The Medical Outcomes Survey Short Form 36 (SF-36) was filled in at home. Organic diseases whose diagnosis was established during the previous year were included in the study by consulting patients' medical records. RESULTS: Patients were found to have a median of three medically explained and 12 medically unexplained symptoms. Mental disorders were found in 83% of cases, associated with other morbidity categories in 78%. The predictive value of symptoms was lower than 26% for diagnosing broad disease categories. CONCLUSIONS: These results depict an extremely difficult scenario for dichotomous diagnostic strategies aimed at classifying patients' symptoms as either organic or functional. Rather than struggling to choose one of these hypotheses, it is suggested that both of them should always be addressed concurrently.
PP - Norway
PY - 2008
SN - 1502-7724; 0281-3432
SP - 99
EP - 105
EP - 
T1 - The diagnostic challenges presented by patients with medically unexplained symptoms in general practice
T2 - Scandinavian journal of primary health care
TI - The diagnostic challenges presented by patients with medically unexplained symptoms in general practice
U1 - Medically Unexplained Symptoms
U2 - 18570008
VL - 26
VO - 1502-7724; 0281-3432
Y1 - 2008
ER -