Excess costs from functional somatic syndromes in Germany — An analysis using entropy balancing

Somatoform disorder in primary care: The influence of co‐morbidity with anxiety and depression on health care utilization

“…Patients with somatoform disorders frequently make use of somatic health care services . However, intervals of up to 25 years between symptom onset and the start of psychological treatment have been reported .…”

“…As a result of the overuse of somatic and underuse of mental health care, impairment remains high while treatment duration and costs continue to rise. The average costs of patients with MUS in Germany are approximately 8 times higher than the general population and rise with increasing symptom severity …”

“…Patients with somatoform disorders frequently make use of somatic health care services. [15][16][17][18] However, intervals of up to 25 years between symptom onset and the start of psychological treatment have been reported. 19,20 In Germany, only 20% to 25% of the patients with a current somatoform disorder receive any kind of mental health care within the last 12 months 21,22 and only half of the patients with a lifetime diagnosis ever seek mental health care.…”

“…The average costs of patients with MUS in Germany are approximately 8 times higher than the general population and rise with increasing symptom severity. 16,23 Although somatoform disorders and MUS are frequently linked with co-morbid mental disorders, 8,24 there is controversy on whether mental co-morbidity leads to higher HCU in patients with somatoform disorders. 10,15,21,25 Being the most common co-morbidities in patients with somatoform disorders, it seems intuitive to assume that depression and anxiety would lead to a higher HCU due to the increase of symptoms present and resulting disability.…”

Hyperarousal in the hospital and what to do about it

“…Therefore, network models may predict the clinical course of multi morbidity phenotypes and might thus help to designate state and severity related targets for complexity interventions. As in psychosis, affective symptoms may act as central network symptoms 398 , thereby moderating or amplifying complex (functional) somatic complaints and care utilization accordingly since stress related disorders are associated with an increase in direct and indirect costs, depending on the complexity (i.e., comorbidity) and the severity of symptoms 399,400 . Regarding potential causation, cumulative serious life threat has been linked with both mental and physical complaints and is associated with an increased number of doctor visits and hospital admissions 401 .…”