Sick leave and work disability in primary care patients with recent-onset multiple medically unexplained symptoms and persistent somatoform disorders: a 10-year follow-up of the FIP study

Rask, Mette Trøllund; Rosendal, Marianne; Fenger‐Grøn, Morten; Bro, Flemming; Ørnbøl, Eva; Fink, Per

doi:10.1016/j.genhosppsych.2014.10.007

Cited by 85 publications

(60 citation statements)

References 40 publications

(49 reference statements)

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“…Moreover, participants with NFS syndromes reported higher comorbidity (47% vs. 23%) and pain disability (M difference = 4.35), which converge with earlier studies on functional impairment and comorbidity in patients with NFS syndromes (Carson, Stone, Hibberd et al, 2011;Dirkzwager & Verhaak, 2007;Fink et al, 2005;Wessely et al, 1999). Other significant demographic differences have been reported earlier as well, including that NFS syndromes were significantly associated with lower educational level (Dirkzwager & Verhaak, 2007), unemployment (Verhaak et al, 2006), and current full-time sickleave (Rask et al, 2015). While we did not measure actual frequency of healthcare visits as did Barsky et al (2005), we similarly found that participants with NFS syndromes were more likely to report that they were in regular contact with healthcare services.…”

Section: Resultssupporting

confidence: 86%

Physicians’ gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient–physician relations

Claréus

Renström

2019

Scandinavian J Psychology

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Nonspecific, functional, and somatoform (NFS) syndromes is an umbrella term for various diagnoses with medically unexplained symptoms. These syndromes are more prevalent among women than among men, and associated with negative preconceptions that can impede rehabilitation. In two studies, we quantitatively assess how patients’ gender affects the diagnostic assessment of NFS syndromes, as well as the healthcare experiences of individuals diagnosed with NFS syndromes. In the first study, our vignette‐based experiment showed that Swedish general practitioners (N = 90) were gender biased in their diagnostic assessment of NFS syndromes, such that a female patient with back pain was more likely to be assigned a NFS syndrome compared to an otherwise identical male patient. In the second study, a large community sample of Swedish individuals with medically explained (n = 432) and unexplained pain (n = 521) evaluated their treating physician's relational conduct. Even after accounting for a variety of sociodemographic variables and other pain characteristics, women with at least one NFS syndrome percieved their physician's relational conduct as significantly poorer than other women as well as men with and without NFS syndromes. When women's pain is more likely than men's to be assessed as NFS, their rehabilitation could be prolonged as pertient alternative diagnoses and treatments are omittied and their negative healthcare experiences lower their volition to partake and persevere in treatment.

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Section: Resultssupporting

confidence: 86%

Physicians’ gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient–physician relations

Claréus

Renström

2019

Scandinavian J Psychology

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“…Associations between functional disorders and anxiety and depression are previously described [26], and an increasing number of studies suggest that persistent and multiple symptoms may lead to severe disability and poor outcome [27]. Patient-reported outcomes (PROs) are increasingly used to improve patient care as a supplement to clinical information [28, 29].…”

Section: Discussionmentioning

confidence: 99%

Self-rated health and functional capacity in individuals reporting overlapping symptoms of gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome - a population based study

et al. 2017

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BackgroundGastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common functional gastrointestinal conditions with a significant impact on daily life. The objectives were to analyse general self-rated health and self-reported functional capacity in adults meeting the criteria for GERD, FD and IBS, respectively, and in individuals who meet the criteria for more than one of the conditions.MethodsA nationwide study of 100,000 individuals aged 20 years and above, randomly selected in the general Danish population. A web-based questionnaire survey formed the basis of this study. Questions regarding FD and IBS were extracted from the ROME III adult questionnaire. Questions regarding GERD were developed based on the Montreal definition. Self-rated health and functional capacity was measured by single global questions.ResultsRespondents meeting the criteria for either GERD, FD or IBS have significantly higher odds of reporting poor self-rated health and impaired functional capacity compared to individuals not experiencing these functional gastrointestinal conditions. Furthermore, respondents with overlapping gastrointestinal (GI) symptom complexes have significantly higher odds of reporting poor self-rated health and impaired functional capacity compared to respondents with symptoms compatible with only one of the symptom complexes.ConclusionsThis study demonstrates that individuals experiencing symptoms of GERD, FD or IBS report poor self-rated health as well as impaired functional capacity. The impact on self-rated health and functional capacity is highest among individuals experiencing overlapping symptoms of GERD, FD and IBS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-017-0622-9) contains supplementary material, which is available to authorized users.

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“…Impaired quality of life and work participation in the FSS are at least as severe as those found in well-defined medical diseases with comparable symptoms [16,17]. Long-term outcome of FSS/bodily distress is variable, but for patients with multiple bodily symptoms it is poor with high rates of disability and sick leave [18]. Notably, low back and neck pain, which have at least large overlap with FSS/bodily distress, are among the top 5 in the global ranking of disability-adjusted life years [19].…”

Section: The Clinical Problem: a Matter Of Perspectivementioning

confidence: 99%

Management of Functional Somatic Syndromes and Bodily Distress

Henningsen

Zipfel²,

Sattel³

et al. 2018

Psychother Psychosom

231

182

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Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease. This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years. We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

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Sick leave and work disability in primary care patients with recent-onset multiple medically unexplained symptoms and persistent somatoform disorders: a 10-year follow-up of the FIP study

Abstract: Both recent-onset and persistent MUS have significant long-term impact on patient functioning in regard to working life; this calls for early recognition and adequate management of MUS in primary care.

Cited by 85 publications

References 40 publications

Physicians’ gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient–physician relations

Physicians’ gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient–physician relations

Self-rated health and functional capacity in individuals reporting overlapping symptoms of gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome - a population based study

Management of Functional Somatic Syndromes and Bodily Distress

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