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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
261 Results
102
Generalized anxiety disorder, with or without co-morbid major depressive disorder, in primary care: prevalence of painful somatic symptoms, functioning and health status
Type: Journal Article
Year: 2010
Publication Place: Netherlands
Topic(s):
Medically Unexplained Symptoms
See topic collection
103
Group therapy for somatization disorders in primary care: maintenance of treatment goals of short cognitive-behavioural treatment one-and-a-half-year follow-up
Type: Journal Article
Year: 2003
Publication Place: Denmark
Abstract: OBJECTIVE: The objective of this study was to evaluate the maintenance of treatment goals of a short cognitive-behavioural group treatment programme for the management of somatization disorders in primary care. METHOD: In a previous controlled 6-month follow-up study, patients with somatization disorders (n=32) improved with respect to illness and somatic preoccupation, hypochondriasis, and medication usage. In the present report the same group of patients were also investigated one-and-a-half year after initial treatment. RESULTS: The long-term follow-up manifested maintained improvement with respect to hypochondriasis. There was additional reduction of anxiety and psychosocial preoccupation, whereas somatization and depression-anxiety scores improved progressively. CONCLUSION: A short cognitive-behavioural group treatment of psychosomatic patients can be useful in primary care and may manifest maintained or progressive beneficial outcome.
Topic(s):
Medically Unexplained Symptoms
See topic collection
105
Health-related quality of life of long-term patients receiving opioid agonist therapy: a nested prospective cohort study in Norway
Type: Journal Article
Year: 2020
Abstract:
BACKGROUND: Opioid dependence carries the highest disease burden of all illicit drugs. Opioid agonist therapy (OAT) is an evidence-based medical intervention that reduces morbidity and mortality. There is limited knowledge on the health-related quality of life (HRQoL) of long-term patients in OAT. This study measures HRQoL and self-perceived health of long-term patients on OAT, compares the scores to a Norwegian reference population, and assesses changes in these scores at 1-year follow up. METHODS: We conducted a nested prospective cohort study among nine OAT outpatient clinics in Norway. 609 OAT patients were included, 245 (40%) followed-up one year later. Data on patient characteristics, HRQoL, and self-perceived health was collected. HRQoL was assessed with the EQ-5D-5L, which measures five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) on a five-point Likert scale (from "no problems" to "extreme problems"). An UK value set was applied to calculate index values (from 0 to 1) for the EQ-5D-5L and compare them to a Norwegian reference population. Self-perceived health was measured with EQ-VAS (from 0 to 100). RESULTS: Mean (standard deviation (SD)) EQ-5D-5L index value at baseline was 0.699 (0.250) and EQ-VAS 57 (22) compared to 0.848 (0.200) and 80(19) for the Norwegian reference population. There were large variations in EQ-5D-5L index values, where 43% had > 0.8 and 5% had < 0.2 at baseline. The lowest EQ-5D-5L index values were observed for female patients, age groups older than 40 years and for methadone users. At follow-up, improvements in HRQoL were observed across almost all dimensions and found significant for mobility and pain/discomfort. Mean (SD) overall index value and EQ-VAS at follow up were 0.729 (0.237) and 59 (22) respectively. CONCLUSION: The average HRQoL and self-perceived health of OAT patients is significantly lower than that of the general population, and lower than what has been found among other severe somatic and psychiatric conditions. Around 34% had very good HRQoL, higher than average Norwegian values, and around 5% had extremely poor HRQoL.
Topic(s):
Measures
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, Medically Unexplained Symptoms
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, Opioids & Substance Use
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107
Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care
Type: Journal Article
Year: 2004
Publication Place: France
Abstract: Somatic symptoms and anxiety symptoms are often disregarded in the detection of depression in primary care. The present investigation examined to what extent somatic and anxiety symptoms recorded with the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) can improve the detection of depression as compared to the General Health Questionnaire-12-item version alone. Data from the World Health Organization study on Psychological Problems in General Health Care were used. The study sample consisted of primary care attenders from 15 centres from all over the world who underwent a psychiatric examination with the CIDI-PHC. Medically unexplained somatic symptoms (back pain, feelings of heaviness/lightness in parts of the body, periods of bodily weakness, seizures/convulsions, permanent tiredness, exhaustion after a minimum of effort) and-to a smaller extent-diverse anxiety symptoms (e.g. feelings of anxiousness/nervousness, feelings of tension, difficulties relaxing) significantly contributed to the detection of depression in a logistic regression analysis. The results confirm the observation that in primary care somatic symptoms play an important role in the manifestation of depressive disorders. The items investigated herein could prove beneficial for future depression screening instruments to improve the detection of depressive disorders in primary care.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links: 
View the DOI record for Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care
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View the PubMed citation for Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care108
Identifiers, or "red flags," of complexity and need for integrated care
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: Because complex medical patients are a subgroup of the medical population and because complexity assessment involves extra effort, preselection of these patients through identifiers is necessary. There is no best identifier for complexity, and the one most suitable for the population served should be selected. This article provides a table with potential identifiers and discusses the difference between disease-oriented screening and treatment and a more generic approach such as complexity screening and complexity management.
Topic(s):
Medically Unexplained Symptoms
See topic collection
View the PubMed citation for Identifiers, or "red flags," of complexity and need for integrated care
Reference Links:
View the DOI record for Identifiers, or "red flags," of complexity and need for integrated care
View DOI Record
View the PubMed citation for Identifiers, or "red flags," of complexity and need for integrated care110
Idiopathic physical symptoms: a common manifestation of psychiatric disorders in primary care
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: Worldwide, patients with common mental disorders, such as depression and anxiety, have a tendency to present first to primary care exhibiting idiopathic physical symptoms. Typically, these symptoms consist of pain and other physical complaints that remain medically unexplained. While in the past, traditional psychopathology emphasized the relevance of somatic presentations for disorders, such as depression, in the last few decades, the "somatic component" has been neglected in the assessment and treatment of psychiatric patients. Medical specialties have come up with a variety of "fashionable" labels to characterize these patients and the new psychiatric nomenclatures, such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, attempt to classify these patients into a separate "somatoform disorders" category. These efforts fall short, and revisionists are asking altogether for the elimination of "somatoform disorders" from future nomenclatures. This review emphasizes the importance of idiopathic physical symptoms to the clinical phenomenology of many psychiatric disorders, offers suggestions to the diagnostic conundrum, and provides some hints for the proper assessment and management of patients with these common syndromes.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links: View the PubMed citation for Idiopathic physical symptoms: a common manifestation of psychiatric disorders in primary care
111
Illness beliefs of depressed Chinese American patients in primary care
Type: Journal Article
Year: 2004
Publication Place: United States
Abstract: This study investigated the illness beliefs of 40 depressed Chinese Americans in a primary care setting using the Exploratory Model Interview Catalogue (EMIC). Twenty-two depressed Chinese Americans (76%) complained of somatic symptoms; 4 (14%) reported psychological symptoms including irritability, rumination, and poor memory. No patients reported depressed mood spontaneously. Yet, 93% endorsed depressed mood when they filled out the CBDI. Twenty-one patients (72%) did not know the name of their illness or did not consider it a diagnosable medical illness, and five patients (17%) attributed their symptoms to pre-existing medical problems. Only three patients (10%) labeled their illness as psychiatric conditions. The patients generally sought help from general hospital (69%), lay help (62%), and alternative treatment (55%) but rarely from mental health professionals (3.5%) for their depressive symptoms. The results suggest that many Chinese Americans do not consider depressed mood a symptom to report to their physicians, and many are unfamiliar with depression as a treatable psychiatric disorder.
Topic(s):
Healthcare Disparities
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, Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Illness beliefs of depressed Chinese American patients in primary care
113
In their own words: qualitative study of high-utilising primary care patients with medically unexplained symptoms
Type: Journal Article
Year: 2009
Publication Place: England
Abstract: BACKGROUND: High utilising primary care patients with medically unexplained symptoms (MUS) often frustrate their primary care providers. Studies that elucidate the attitudes of these patients may help to increase understanding and improve confidence of clinicians who care for them. The objective of this study was to describe and analyze perceptions and lived experiences of high utilising primary care patients with MUS. METHODS: A purposive sample of 19 high utilising primary care patients for whom at least 50% (69.6% in this sample) of visits for two years could not be explained medically, were encouraged to talk spontaneously about themselves and answer semi-structured questions. Verbatim transcripts of interviews were analyzed using an iterative consensus building process. RESULTS: Patients with MUS almost universally described current and/or past family dysfunction and were subjected to excessive testing and ineffective empirical treatments. Three distinct groups emerged from the data. 1) Some patients, who had achieved a significant degree of psychological insight and had success in life, primarily sought explanations for their symptoms. 2) Patients who had less psychological insight were more disabled by their symptoms and felt strongly entitled to be excused from normal social obligations. Typically, these patients primarily sought symptom relief, legitimization, and support. 3) Patients who expressed worry about missed diagnoses demanded excessive care and complained when their demands were resisted. CONCLUSION: High utilising primary care patients are a heterogeneous group with similar experiences and different perceptions, behaviours and needs. Recognizing these differences may be critical to effective treatment and reduction in utilisation.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links:
View the DOI record for In their own words: qualitative study of high-utilising primary care patients with medically unexplained symptoms
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View the PubMed citation for In their own words: qualitative study of high-utilising primary care patients with medically unexplained symptoms115
Integrating Mental and Physical Health Services Using a Socio-Emotional Trauma Lens
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Healthcare Disparities
See topic collection
, Medically Unexplained Symptoms
See topic collection
Reference Links: View the PubMed citation for Integrating Mental and Physical Health Services Using a Socio-Emotional Trauma Lens
116
Integrating psychologists into the Canadian health care system: the example of Australia
Type: Journal Article
Year: 2009
Publication Place: Canada
Abstract: Canada and Australia share many similarities in terms of demographics and the structure of their health systems; however, there has been a divergence in policy approaches to public funding of psychological care. Recent policy reforms in Australia have substantially increased community access to psychologists for evidence-based treatment for high prevalence disorders. In Canada, access remains limited with the vast majority of consultations occurring in the private sector, which is beyond the reach of many individuals due to cost considerations. With the recent launch of the Mental Health Commission of Canada, it is timely to reflect on the context of the current Canadian and Australian systems of psychological care. We argue that integrating psychologists into the publicly-funded primary care system in Canada would be feasible, beneficial for consumers, and cost-effective.
Topic(s):
Medically Unexplained Symptoms
See topic collection
, Healthcare Policy
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Reference Links: View the PubMed citation for Integrating psychologists into the Canadian health care system: the example of Australia
117
Interventions on frequent attenders in primary care. A systematic literature review
Type: Journal Article
Year: 2008
Publication Place: Norway
Abstract: OBJECTIVE: To analyse which interventions are effective in influencing morbidity, quality of life, and healthcare utilization of frequently attending patients (FAs) in primary care. METHODS: A systematic literature search was performed for articles describing interventions on FAs in primary care (Medline, Embase, and PsycINFO). Outcomes were morbidity, quality of life (QoL), and use of healthcare. Two independent assessors selected all randomized clinical trials (RCT) and assessed the quality of the selected RCTs. Results. Five primary care based RCTs were identified. Three RCTs used frequent attendance to select patients at risk of distress, major depression, and anxiety disorders. These RCTs applied psychological and psychiatric interventions and focused on undiagnosed psychiatric morbidity of FAs. Two of them found more depression-free days and a better QoL after treating major depressive disorder in FAs. No other RCT found any positive effect on morbidity or QoL. Two RCTs studied an intervention which focused on reducing frequent attendance. No intervention significantly lowered attendance. Due to the difference in study settings and the variation in methods of selecting patients, meta-analysis of the results was not possible. CONCLUSION: No study showed convincing evidence that an intervention improves QoL or morbidity of frequent attending primary care patients, although a small effect might be possible in a subgroup of depressed frequent attenders. No evidence was found that it is possible to influence healthcare utilization of FAs.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links:
View the DOI record for Interventions on frequent attenders in primary care. A systematic literature review
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View the PubMed citation for Interventions on frequent attenders in primary care. A systematic literature review118
Introduction to the special issue on medically unexplained symptoms: background and future directions
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: This special issue is devoted to the topic of medically unexplained symptoms (MUS), a heterogeneous group of conditions characterized by persistent physical symptoms that cannot be explained by medical illness or injury. Although psychological factors have long been regarded as central to these problems, patients with MUS have typically been managed within medical settings and referrals to mental health services have been relatively rare. In recent years, however, interest in the psychological nature and treatment of MUS has expanded, culminating in the development of tailored psychological interventions for these conditions. This, coupled with the increasing willingness of practitioners to diagnose conditions such as chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome, has led to an increase in the number of patients who are referred for psychological treatment. At present, however, many psychological therapists are unfamiliar with the literature on MUS. With this in mind, this special issue presents a series of papers that provide an overview of what is known about the nature, aetiology and treatment of medically unexplained illness. This introductory paper provides general information about the clinical presentation, diagnosis, classification, terminology and epidemiology of MUS in adults, and concludes with an examination of important areas for future development in the field. Subsequent papers address the psychological mechanisms [Deary, V., Chalder, T., & Sharpe, M. (2007-this issue). The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review. Clinical Psychology Review; Iverson, A., Chalder, T., & Wessely, S. (2007-this issue). Gulf war illness: Lessons from medically unexplained illness. Clinical Psychology Review; Rief, W., & Broadbent, E. (2007-this issue). Explaining medically unexplained symptoms: Models and mechanisms. Clinical Psychology Review; Roelofs, K., & Spinhoven, P. (2007-this issue). Trauma and medically unexplained symptoms: Towards an integration of cognitive and neuro-biological accounts. Clinical Psychology Review] and management [Deary, V., Chalder, T., & Sharpe, M. (2007-this issue). The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review. Clinical Psychology Review] of these conditions. A separate overview of the literature on MUS in children and adolescents is provided by Eminson [Eminson, J. (2007-this issue). Medically unexplained symptoms in children and adolescents. Clinical Psychology Review].
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links:
View the DOI record for Introduction to the special issue on medically unexplained symptoms: background and future directions
View DOI Record
View the PubMed citation for Introduction to the special issue on medically unexplained symptoms: background and future directions119
Is co-morbid depression adequately treated in patients repeatedly referred to specialist medical services with symptoms of a medical condition?
Type: Journal Article
Year: 2012
Topic(s):
Measures
See topic collection
, Medically Unexplained Symptoms
See topic collection
120
Late-life anxiety disorders among Puerto Rican primary care patients: impact on well-being, functioning, and service utilization
Type: Journal Article
Year: 2004
Publication Place: United States
Abstract: With the growing population of older Hispanic adults there is a need for additional research on the mental health care of this patient group. This study explored the impact of anxiety disorders on the health status of 291 older (>/=50 years) Puerto Rican primary care patients (n = 65 with anxiety disorders, n = 226 without anxiety disorders). All analyses controlled for potential confounding variables, including depression diagnosis and physical health burden. Logistic regression indicated that anxiety disorders were associated with higher psychological distress, suicidality, and emergency room service utilization, as well as lower instrumental functioning and perceived health quality. Analysis of covariance indicated that both anxiety disorder status and history of ataque de nervios were related to higher percentages of lifetime somatic symptoms. These data highlight the need for improved recognition and treatment of anxiety disorders in older Puerto Rican adults.
Topic(s):
Healthcare Disparities
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, Medically Unexplained Symptoms
See topic collection