Multiple symptoms and medically unexplained symptoms — Closely related concepts in general practitioners’ evaluations. A linked doctor–patient study

Tschudi-Madsen, Hedda; Kjeldsberg, Mona; Natvig, Bent; Ihlebæk, Camilla; Dalen, Ingvild; Straand, Jørúnd; Bruusgaard, Dag

doi:10.1016/j.jpsychores.2013.01.003

Cited by 8 publications

(5 citation statements)

References 41 publications

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“…22 Se ha demostrado su utilidad cuando lo emplean profesionales sin experiencia psiquiátrica en medicina de atención primaria. 23 Por ello, los médicos de familia necesitan una herramienta para facilitar el tratamiento de estos pacientes con SFMNE. La relevancia radica en ayudarlos a comprender el origen de sus síntomas.…”

Section: Discussionunclassified

Atribución de síntomas en pacientes con síntomas médicamente inexplicables. Un estudio de validación y desarrollo de la escala

Ramírez-Aranda¹,

Morales-Ramírez²,

Frías-Gómez³

et al. 2022

GMM

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Introducción: En la atención de pacientes con síntomas físicos médicamente no explicables (SFMNE) es importante lo que el paciente piensa de sus síntomas. Objetivo: Validar propiedades psicométricas de una escala de atribución del síntoma en pacientes con SFMNE y verificar su confiabilidad. Métodos: Se entrevistó a una muestra no probabilística de 400 pacientes adultos, hombres y mujeres, en la consulta de un hospital con medicina familiar, 200 con SFMNE y 200 con patología orgánica concreta. Se diagnosticó a cada grupo con criterios definidos y se aplicó una escala con validez de contenido y de constructo por medio de análisis de componentes principales con rotación varimax. Resultados: La escala quedó integrada por 12 reactivos con dos factores, uno de atribución psicosocial y otro de atribución orgánica del síntoma. El factor de origen psicosocial tuvo una varianza de 49.7 %. La prueba de bondad de ajuste mostró que la matriz de correlaciones fue adecuada y la prueba de esfericidad de Bartlett indicó significación estadística (p < 0.0001); el alfa de Cronbach fue de 0.841. Conclusión. La escala mostró una validez de constructo aceptable y buena confiabilidad y estabilidad. Se discuten las implicaciones de estos resultados para la investigación de mediciones futuras.

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Section: Discussionunclassified

Atribución de síntomas en pacientes con síntomas médicamente inexplicables. Un estudio de validación y desarrollo de la escala

Ramírez-Aranda¹,

Morales-Ramírez²,

Frías-Gómez³

et al. 2022

GMM

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“…Asthenia (A04) is a symptom diagnosis according to ICPC-2 and may be used for tiredness/asthenia symptoms alone. However, asthenia is also associated with medically unexplained symptoms [ 25 ], which in turn are strongly associated with the reporting of multiple symptoms [ 29 ]. Mental health problems are also associated with a high number of symptoms [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Patients in general practice share a common pattern of symptoms that is partly independent of the diagnosis

Kjeldsberg

Tschudi-Madsen

Mdala

et al. 2021

Scandinavian Journal of Primary Health Care

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Objective: To describe self-reported symptoms among patients in general practice and to explore the relationships between symptoms experienced by patients and diagnoses given by general practitioners. Design: Doctor-patient questionnaires focusing on patients' self-reported symptoms during the past 7 days and the doctors' diagnoses. Setting: General practices in urban and suburban areas in Southeast Norway. Subjects: Forty-seven general practitioners who included 866 patients aged 18 years on a random day in practice. Results: The most frequently reported symptoms were tiredness (46%), lower back pain (43%), neck pain (41%), headache (39%), shoulder pain (36%), and sleep problems (35%). Women had a significantly higher prevalence than men for 16 of 38 symptoms (p < 0.05). The mean number of symptoms was 7.5 (range, 0-32; women, 8.1; men, 6.5, p < 0.05). Regression analysis showed that patients who received a social security grant had 59% more symptoms than those who were employed and that people with asthenia and depression/anxiety had 44% and 23% more symptoms, respectively than those with all other diagnoses. The patterns of symptoms reported showed similar patterns across the five most prevalent diagnoses. Conclusions: Patients in general practice report a number of symptoms and share a common pattern of symptoms, which appear to be partly independent of the diagnoses given. These findings suggest that symptoms are not necessarily an indication of disease. KEY POINTSPatients consulting general practitioners have a high number of self-reported symptoms. The most frequent symptoms are tiredness, lower back pain, neck pain, headache, shoulder pain, and sleep problems. Patients diagnosed with asthenia and depression/anxiety report the highest number of symptoms. Selected diagnoses show similar patterns in symptom distribution. Symptoms are not necessarily an indication of disease.

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“…Women reported more PCT symptoms and lower QoL than men. Women in general are known to report lower QoL [30] and more subjective health complaints [31,32]. Analysis of the associations between self-reported symptoms and HRQoL showed a strong association between symptoms and PCS in men, while this association was only moderate in women (Table 3) The association between mental aspects and HRQoL was not present in men, and only moderately in women, which is in line with the results of a previous study on illness perception in PCT, where sex was not associated with porphyria related psychological distress [11].…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life in porphyria cutanea tarda: a cross-sectional registry based study

Andersen

Thomsen

Enes

et al. 2020

Health Qual Life Outcomes

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Background: Porphyria cutanea tarda (PCT) is a rare, photosensitive disease characterized by skin fragility and blistering on sun-exposed areas. There is little previous research on how this condition affects health-related quality of life (HRQoL) and to the best of our knowledge this is the largest sample of PCT patients surveyed about their HRQoL. The aims of this study were to describe HRQoL, symptoms, susceptibility factors, disease activity and treatment in patients with PCT, and investigate the associations between these factors. Methods: This is a cross-sectional, retrospective study based on patient-reported outcome and laboratory data. The Norwegian Porphyria Centre diagnoses all patients with PCT in Norway, all of whom are invited to participate in the Norwegian Porphyria Registry. Between December 2013-2015, 111 patients received a postal questionnaire and invitation to participate. Results: Sixty-eight persons responded, with seven being excluded due to prolonged response time or missing information, resulting in 61 participants in the final analyses (55%). Median age was 60 years and 33 were female. We found a moderate negative relationship between the type and localisation of PCT symptoms and both mental (r = −.354 p < 0.01) and physical (r = −.441, p < 0.01) aspects of HRQoL. Participants who had started treatment when answering the questionnaire reported significantly better physical functioning and less bodily pain than those who had not started treatment. We did not observe an association between biochemical markers of disease activity and symptoms or HRQoL. Itching, a symptom that has received little attention in PCT was reported by 59% of the participants. Conclusions: Our results show that reduced HRQoL is associated with more symptoms and not having started treatment. PCT is a rare disease, and there is a need for the development of best-practice guidelines to facilitate good patient care.

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Multiple symptoms and medically unexplained symptoms — Closely related concepts in general practitioners’ evaluations. A linked doctor–patient study

Cited by 8 publications

References 41 publications

Atribución de síntomas en pacientes con síntomas médicamente inexplicables. Un estudio de validación y desarrollo de la escala

Atribución de síntomas en pacientes con síntomas médicamente inexplicables. Un estudio de validación y desarrollo de la escala

Patients in general practice share a common pattern of symptoms that is partly independent of the diagnosis

Health-related quality of life in porphyria cutanea tarda: a cross-sectional registry based study

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