Symptom attribution and stress level in patients with medically unexplained symptoms in a Mexican emergency department

Abstract

Background: Patients who come to the emergency department are different from those seen in outpatient clinics. The former suffer greater stress. Aim: Establish an association between the attribution of the symptoms (psychosocial or organic) by the patient and the level of perceived stress in patients with Medically Unexplained Physical Symptoms (MUS) in an emergency department. Methods: A correlational cross-sectional study was conducted in 138 patients with MUS in the emergency department of a 3rd level public hospital where the psychosocial or organic attribution of nonspecific symptom(s) by patients and the perceived stress were measured with validated scales. Bivariate analysis was performed with Chi square for categorical variables, and a Spearman correlation, p <0.05. Results: 75% of patients with psychosocial attribution have higher stress compared to patients with organic symptom attribution (25%). In Spearman’s correlation, a medium but statistically significant correlation was obtained. Conclusions: The psychosocial attribution of the patient’s complaint might coexist in MUS patients with higher level of perceived stress by the patients. Health professionals might need to address both psychosocial attributions and stress in MUS patients.