Medically unexplained physical symptoms in patients attending a medical outpatient clinic in a tertiary hospital in North India

• Published in: Asian journal of psychiatry 2018-02, Vol.32, p.99-104
• Main Authors: Sharma, Mohit, Singh, Shubh Mohan, Avasthi, Ajit, Varma, Subhash C., Sharma, Aman, Suri, Vikas
• Format: Article
• Language: English
• Subjects: Comorbidity; Disability; Health anxiety; Medically unexplained physical symptoms; Psychiatric morbidity; Quality of life
• ISSN: 1876-2018; 1876-2026
• DOI: 10.1016/j.ajp.2017.11.022

•Symptom duration in patients with Medically Unexplained physical symptoms (MUPS) is similar to medically explained physical symptoms (MEPS.•Patients with MUPS have more number and severity of somatic symptoms as compared to patients with MEPS.•Patients with MUPS have greater psychiatric morbidity, more health anxiety, disability and impairment in quality of life as compared to MEPS.•There is a need to screen and identify patients with MUPS in medical settings and manage them accordingly. Medically unexplained physical symptoms (MUPS) are commonly seen across health care settings. Earlier studies have focussed on prevalence, cost-utilization and burden. Data from India is scarce. Patients with persistent MUPS have more impairment and psychological distress. This study was designed to assess psychological morbidity, health anxiety (HA), somatic symptom load, disability, quality of life (QOL) in patients with persistent MUPS presenting to a general medical outpatient service and compare it with patients with medically explained physical symptoms (MEPS). The study was conducted in the outpatient service of the Department of Internal Medicine in a tertiary hospital in North India. Persistent MUPS was defined as physical symptoms of at least 3 months duration leading to dysfunction and with no identifiable medical cause. 70 patients with persistent MUPS and MEPS each were recruited. Psychiatric morbidity was assessed using the Mini International Neuropsychiatric interview, somatic symptom load with Patient Health Questionniare-15 (PHQ-15), HA with Whiteley Index, disability with WHODAS 2.0 and QOL with WHOQOL-Bref. Both the groups were comparable on socio-demography and length of symptoms. Prevalence of psychiatric disorders and HA was significantly greater in MUPS. Patients with persistent MUPS had significantly more health care utilization, number and burden of somatic symptoms, greater disability and worse QOL. Patients with persistent MUPS have a different profile when compared to MEPS. There is a need to screen and identify patients with MUPS and manage them keeping in mind the psychological factors and chronic nature and number of symptoms.