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Front. Psychiatry | doi: 10.3389/fpsyt.2018.00626

Medically unexplained physical symptoms in hospitalized patients: a 9-year retrospective observational study

  • 1Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria, Italy
  • 2Department of Medicine and Surgery, Section of Psychiatry, Università degli Studi dell'Insubria, Italy

Introduction: “Medically unexplained physical symptoms” defines a subgroup of patients presenting physical symptoms of unclear origin. The study aims to profile clinical and sociodemographic characteristics of patients with MUPS.

Materials and Methods: This 9-years observational retrospective study assesses patients admitted between 2008 and 2016 in the divisions of neurology and gastroenterology. Socio-demographic and clinical variables were evaluated: gender, age, diagnosis or diagnostic hypothesis, presence of psychiatric comorbidities, psychiatric evaluation, pharmacological treatment, number of admissions/visits.

Results: Among 2,479 neurological patients 10.1% presented MUPS. Patients were more frequently female (63.5%), with a mean age of 50 years. Reported symptoms were headache (22.6%), seizures (8.7%), vertigo (5.9%), fibromyalgia (5.5%), paresthesia (5.1%), visual disturbances (5.1%), amnesia (3.9%). The diagnosis was somatoform disorder in 6.3% of cases, conversion disorder in 2.7%, and somatic symptom disorder in 1.5% only. 2,560 outpatients were evaluated in gastroenterology division. 9.6% (n=248) of patients had MUPS; 62.1% of them were female. The most affected age group ranged between 15 and 45 years. The most frequent diagnoses were functional abdominal pain (50%), dysmotility-like dyspepsia (26.6%), irritable bowel syndrome (10.4%), meteorism of unknown cause (2.4%), hiccup (1.6%), burning mouth syndrome (1.2%). No patients received a diagnosis of somatic symptom disorder.

Discussion: Patients with MUPS are more often females, of middle age, with self-referred specific symptomatology. While neurological patients received a diagnostic-therapeutic approach in line with the literature, gastroenterological patients mainly received antipsychotics. A more comprehensive assessment and a development of psychoeducational interventions are needed to improve patients’ quality and quantity of life.

Keywords: somatic symptoms disorders, Medically unexplained physical symptoms (MUPS), Psychosomatic Medicine, Consultative psychiatry, Psychosocial Interventions

Received: 30 Jul 2018; Accepted: 05 Nov 2018.

Edited by:

Andrea Fiorillo, Università degli Studi della Campania "Luigi Vanvitelli" Naples, Italy

Reviewed by:

Giorgio Di Lorenzo, Università degli Studi di Roma Tor Vergata, Italy
Bernd Löwe, University Medical Center Hamburg-Eppendorf, Germany  

Copyright: © 2018 Poloni, Ielmini, Caselli, Ceccon, Bianchi, Isella and Callegari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Camilla Callegari, Università degli Studi dell'Insubria, Department of Medicine and Surgery, Section of Psychiatry, Varese, Italy, camilla.callegari@uninsubria.it