1
|
Iloson C, Praetorius Björk M, Möller A, Sundfeldt K, Bernhardsson S. Awareness of somatisation disorder among Swedish physicians at emergency departments: a cross-sectional survey. BMC Psychiatry 2024; 24:223. [PMID: 38515091 PMCID: PMC10958883 DOI: 10.1186/s12888-024-05652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Somatisation is a highly prevalent psychiatric syndrome in both women and men, in which psychological distress is manifested in physical symptoms without a medical explanation. Many patients with somatisation disorder are high healthcare utilisers, particularly at emergency departments. Unnecessary investigations and diagnostic operations occur frequently, which cause both patient suffering and a significant burden on the healthcare system. Emergency department physicians' awareness of somatisation and its manifestations has not previously been studied. This study aimed to investigate awareness about somatisation disorder among physicians working at emergency departments in western Sweden, and to explore differences between gender, specialty, and work experience. METHODS A web-based, cross-sectional survey consisting of six dichotomous questions about somatisation disorder was conducted, in December 2021 - January 2022, among licensed physicians of various specialties working at emergency departments in western Sweden. Descriptive analyses and comparative analyses were performed to investigate differences between gender, type of specialty, and years of practice. Data were analysed using chi2 tests and Fisher's exact test. RESULTS Of the 526 eligible physicians who received the survey, 241 responded; response rate 45.8%. The majority of the respondents (56.4%) were women, and most (35.3%) were specialised in obstetrics/gynaecology. Average years of work experience was 11.1 (SD 8.7) years. Although 71% of respondents were aware of the diagnosis, only 7% knew the diagnostic criteria and only 6% had ever diagnosed a patient with somatisation disorder. Female physicians were more aware of underlying factors than their male colleagues (55.7% vs. 38.2%; p = .010). Type of specialty or years of practice did not affect awareness. CONCLUSIONS Awareness of somatisation disorder is low among physicians working at emergency departments in western Sweden. The findings suggest a need to increase awareness and knowledge and provide training in diagnosing the condition, to ensure correct decisions and optimal patient management. Clinical guidelines need to be developed to support diagnosis, investigation, and treatment, in Sweden as well as internationally.
Collapse
Affiliation(s)
- Carina Iloson
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Region Västra Götaland Competence Centre on Intimate Partner Violence, Gothenburg, Sweden.
- Masthugget Gynaecology and Obstetrics Clinic, Region Västra Götaland, Gothenburg, Sweden.
| | - Marcus Praetorius Björk
- Research, Education, Development and Innovation, Region Västra Götaland, Primary Health Care, Gothenburg, Sweden
- General Practice/Family medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Möller
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, Stockholm South Hospital, Stockholm, Sweden
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Susanne Bernhardsson
- Research, Education, Development and Innovation, Region Västra Götaland, Primary Health Care, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Unit of Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
2
|
Kuanar Baboo AG, Ranjan P, Kaur T, Rawat N, Sarkar S, Kaloiya G, Singh A, Babu N, Baitha U, Prakash B. Evaluation of Tools to Assess Symptoms and Symptom Severity in Patients With Medically Unexplained Physical Symptoms: A Systematic Review and Narrative Synthesis. Cureus 2024; 16:e56204. [PMID: 38618386 PMCID: PMC11016182 DOI: 10.7759/cureus.56204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
A substantial portion of patients presenting to healthcare settings exhibit physical symptoms lacking clear, demonstrable organic causes. Accurate assessment of symptom severity is crucial for documenting outcomes and establishing treatment efficacy. This systematic review and narrative synthesis aims to provide researchers with insights into available and validated tools for assessing medically unexplained physical symptoms (MUPS). It involved comprehensive searches across electronic databases, including PubMed, Wiley, and Cochrane, adhering to PRISMA and COSMIN guidelines. The study comprised two phases: Phase 1 systematically reviewed tools for assessing MUPS symptoms and severity, while Phase 2 conducted a narrative synthesis of their measurement properties, focusing on validity and reliability. Out of 14,459 records, 191 articles were identified, leading to the recognition of 16 validated tools for assessing MUPS symptoms and severity. Most tools demonstrated excellent internal consistency and structural validity. However, the majority lacked cross-cultural validity. The choice of tools for the assessment of MUPS will assist clinicians and researchers in determining the severity of MUPS and developing a tailored treatment plan to improve the physical and psychological functioning of these patients.
Collapse
Affiliation(s)
| | - Piyush Ranjan
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Tanveer Kaur
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Nandini Rawat
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Siddharth Sarkar
- Psychiatry, All India Institute of Medical Sciences, New Delhi, IND
| | | | - Amandeep Singh
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Natesh Babu
- Yoga, Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, IND
| | - Upendra Baitha
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Bindu Prakash
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| |
Collapse
|
3
|
Aakansha, Singh A, Ranjan P, Kaur T, Rawat N, Sarkar S, Kaloiya GS, Sahu A, Deb KS, Baitha U. Development and Validation of a Symptom Scale for Indian Patients With Medically Unexplained Physical Symptoms. Cureus 2024; 16:e55956. [PMID: 38618330 PMCID: PMC11009479 DOI: 10.7759/cureus.55956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/16/2024] Open
Abstract
Introduction Patients with medically unexplained physical symptoms (MUPS) account for a substantial proportion of patients visiting the outpatient department. Diagnosis of MUPS is a challenge for most physicians. An accurate diagnosis relies on obtaining a detailed history from patients regarding the nature of their symptoms, their onset, and any associated aggravating or relieving factors. This study aims to develop a symptom scale for Indian patients with MUPS. Methods The study had a mixed-method study design. Phase 1 involved designing the questionnaire using qualitative techniques, such as literature reviews, focus-group discussions, expert evaluation, and pre-testing of a Hindi and English language Likert-rated interviewer-administered scale. In phase 2, the construct validity of the questionnaire was established using quantitative approaches among 116 patients diagnosed with MUPS. Results The final questionnaire consists of 38 items, with good internal consistency (Cronbach 𝛂 = 0.916). Confirmation sampling adequacy for factor analysis was done using the Kaiser-Meyer-Olkin test (KMO value = 0.792) and Bartlett's test of sphericity (p < 0.001). The newly developed scale showed a Pearson correlation coefficient of 0.568 (p < 0.001) with Patient Health Questionnaire (PHQ)-15 scores. Conclusion A reliable and valid tool has been developed to assess patients' symptoms with MUPS in English and Hindi languages. This questionnaire can be used for assessment, screening, and diagnostic purposes as well as to chart longitudinal changes in patients with MUPS.
Collapse
Affiliation(s)
- Aakansha
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Amandeep Singh
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Piyush Ranjan
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Tanveer Kaur
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Nandini Rawat
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Siddharth Sarkar
- Psychiatry, All India Institute of Medical Sciences, New Delhi, IND
| | | | - Anamika Sahu
- Clinical Psychology, All India Institute of Medical Sciences, New Delhi, IND
| | | | - Upendra Baitha
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| |
Collapse
|
4
|
Yager J, Kay J. The Kvetch: Assessment, Pathogenesis, and Treatment of Patients Who Are Clinically Impaired by Chronic Complaining. J Nerv Ment Dis 2024; 212:4-11. [PMID: 37788338 DOI: 10.1097/nmd.0000000000001717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
ABSTRACT Clinicians often encounter patients whose presentations are characterized by long lists of complaints about their biological, psychological, interpersonal, and social conditions. The problems on which the complaints are based are variably reality-based and variably modifiable. Some of these patients display chronic complaining as a core, distinguishing feature. Accordingly, the aims of this article are to consider excesses of chronic complaining as psychiatric phenomena, explore possible pathogenetic contributions, describe approaches for treating conditions marked by clinically pertinent chronic complaining, and suggest areas for future research. Based on clinical observations enhanced by selective narrative literature review, we delineate and differentiate four groups of patients: 1) situational complainers; 2) chronic complainers due to unidentified medical problems; 3) mood-induced chronic complainers; and 4) personality-driven pan-dimensional chronic complainers. The last-mentioned group consists of help-seeking versus help-rejecting subtypes, the latter including a subset we designate as malignant chronic complainers. Strategies for managing these patients begin with detailed assessment of all complaints, ascertaining reality-based contributions to the complaints, including those initiated by patients themselves. Management approaches use specific biopsychosocial techniques based on patient-centered particulars. Psychotherapeutic strategies center on compassionate, empathic witnessing. Specific tactics include attending to unresolved grief and trauma, behavioral activation, cognitive and narrative restructuring and reframing methods, mentalizing and imaginal approaches, and psychodynamic methods including attention to attachment issues and transference. Sources of countertransference reactions to these patients should be identified and can be addressed. The many questions raised by these patients' presentations merit further research.
Collapse
Affiliation(s)
- Joel Yager
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
| | - Jerald Kay
- Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| |
Collapse
|
5
|
Singh A, Ranjan P, Kumari A, Kaur T, Sarkar S, Sahu A, Prakash B, Kaloiya GS, Baitha U, Rawat N, Kuanar Baboo AG. Perspectives of patients, caregivers, and healthcare professionals in Indian context: A qualitative study on Medically Unexplained Physical Symptoms (MUPS). JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:119. [PMID: 37397120 PMCID: PMC10312410 DOI: 10.4103/jehp.jehp_1513_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 07/04/2023]
Abstract
BACKGROUND Approximately one-fourth of individuals who seek treatment in outpatient medical settings have Medically Unexplained Physical Symptoms (MUPS), a prevalent medical ailment. Patients with MUPS have a considerable functional impairment, and a lower quality of life, and may also have co-occurring psychiatric conditions. MATERIALS AND METHODS Eleven Focus Group Discussions (FGDs) (four virtual and seven face-to-face) were conducted with patients, caregivers, and healthcare professionals in 2021 in a tertiary care hospital in New Delhi. Thematic analysis was carried out using QSR Nvivo software. RESULTS A total of 36 participants were recruited in the study, including patients with MUPS (n = 12), caregivers (n = 10), and healthcare professionals (n = 14) dealing with the patients of MUPS. Three themes were identified: burden of MUPS, symptom profile of patients with MUPS, and psychological profile of patients with MUPS. These were further categorized into eight sub-themes: prevalence, symptoms, course of illness, improvement with treatment, duration of symptoms, attribution of symptoms, psychological impact, and coping strategies. CONCLUSION The study helped us to gain insight into the characteristics and experiences of patients, caregivers, and healthcare professionals dealing with MUPS in an Indian setup. Greater awareness of MUPS and training of care providers about the occurrence, management, and referral of MUPS can be beneficial.
Collapse
Affiliation(s)
- Amandeep Singh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Aakansha Kumari
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Tanveer Kaur
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Anamika Sahu
- Student Wellness Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Bindu Prakash
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Gauri Shankar Kaloiya
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nandini Rawat
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ananta Gopal Kuanar Baboo
- Division of Yoga and Humanities, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| |
Collapse
|
6
|
Kaur T, Ranjan P, Sarkar S, Kaloiya GS, Khan M, Aakansha, Bhatia H. Psychological interventions for medically unexplained physical symptoms: A systematic review and meta-analysis. Gen Hosp Psychiatry 2022; 77:92-101. [PMID: 35580397 DOI: 10.1016/j.genhosppsych.2022.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Individuals seeking treatment for physical symptoms having unknown etiology are common in the primary healthcare setup. Factors such as biomedical, environmental, social, and psychological ones are expected to play an important role in the treatment of Medically Unexplained Physical Symptoms (MUPS). Therefore, this systematic review and meta-analysis aimed to investigate the efficacy of psychological interventions for the treatment of MUPS. METHOD Studies were selected using different electronic databases (PubMed, Wiley, Cochrane), to identify RCTs published in the last 11 years on psychological interventions to treat MUPS. A total of 12 studies were finalized for systematic review and 7 for meta-analysis based on the inclusion criteria. The risk of bias was assessed by the two reviewers independently using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. OpenMeta[Analyst] was used to perform meta-analysis. RESULTS The findings revealed that psychological interventions can possibly be effective in treating patients with MUPS. Somatic symptom severity and depression improved in the intervention groups as compared to controls, while anxiety, and physical and mental component summary of Short-Form General Health Survey 36 did not significantly improve in the intervention group. CONCLUSION A tailored module including psychological interventions to deal with these patients in primary care may be useful in improving the overall functioning of the individuals.
Collapse
Affiliation(s)
- Tanveer Kaur
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Siddharth Sarkar
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Gauri Shanker Kaloiya
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Munnoo Khan
- Morarji Desai National Institute of Yoga, New Delhi, India
| | - Aakansha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Harpreet Bhatia
- Department of Psychology, University of Delhi, New Delhi, India
| |
Collapse
|
7
|
Rady A, Alamrawy RG, Ramadan I, El Raouf MA. Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt. Clin Pract Epidemiol Ment Health 2021; 17:136-145. [PMID: 34880925 PMCID: PMC8595980 DOI: 10.2174/1745017902117010136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is a high incidence of alexithymia in people who report medically unexplained symptoms. There have been limited studies on the prevalence of alexithymia in patients with medically unexplained physical symptoms (MUPS) in various ethnic and cultural backgrounds. OBJECTIVE This study aimed to estimate the prevalence of alexithymia in patients with MUPS and examine their socio-demographic data. METHODS In this cross-sectional study, 196 patients with MUPS were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. Patients completed a structured interview; socio-demographic and medical history data were collected. Somatic symptom severity was assessed using the Arabic version of the Patient Health Questionnaire (PHQ-15). Alexithymia was assessed using the Arabic version of the Toronto Alexithymia Scale. RESULTS General fatigue was the most common complaint observed, followed by headache and dyspepsia. In addition, 73.5% of patients had a high Patient Health Questionnaire score, 17.9% had somatic symptoms of medium severity, while 8% and 0.5% had low and marginal somatic symptoms, respectively. Alexithymia was presented in 49.5%, 22.9% had no alexithymia, and 27.6% had borderline/intermediate alexithymia.A weak positive correlation (r<0.4) was found between somatic symptom severity and alexithymic psychopathology (r=0.277;p<0.05). Only the 'difficulty identifying feelings' dimension of alexithymic psychopathology was positively correlated with the severity of somatic symptoms (r=0.271;p<0.05). CONCLUSION Alexithymia is associated with the development of MUPS.
Collapse
Affiliation(s)
- Ahmed Rady
- Department of Psychiatry, Alexandria University, School of Medicine, Alexandria, Egypt
| | - Roa Gamal Alamrawy
- Mamoura Psychiatric Hospital, Secretariat of Mental Health and Addiction Treatment, Alexandria, Egypt
| | - Ismail Ramadan
- Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt
| | - Mervat Abd El Raouf
- Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt
| |
Collapse
|
8
|
Goel A, Ranjan P, Klanidhi KB, Deb KS, Sarkar S, Kaur T, Sahu A, Baitha U, Chakrawarty A, Kumar A. Comprehensive Treatment Module for Medically Unexplained Physical Symptoms - A Guide for General Practitioners. Cureus 2021; 13:e16263. [PMID: 34414039 PMCID: PMC8364782 DOI: 10.7759/cureus.16263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose: This study was aimed to develop a comprehensive treatment module that the general physician can use to manage patients with Medically Unexplained Physical Symptoms (MUPS) at a primary care level. Methods: This comprehensive module was developed after a literature review followed by its validation by a two-step Delphi technique with experts from internal medicine, psychiatry, and clinical psychology. Results: The developed module for the patients with MUPS includes case diagnosis, initial evaluation, strategy for referral, and a comprehensive treatment module. The comprehensive treatment module includes symptom discussion, rapport establishment, physical health counselling, stress management, cognitive strategies for symptom control, comorbidities treatment, and medical management. Conclusion: The developed module has unique features, such as intensive sessions with these patients, a patient-specific treatment strategy, and a holistic approach incorporating pharmacological and non-pharmacological interventions. General Practitioners across the world can use this comprehensive treatment module for the management of patients with MUPS.
Collapse
Affiliation(s)
- Aastha Goel
- Internal Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Piyush Ranjan
- Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Kamal B Klanidhi
- Internal Medicine: Geriatrics, All India Institute of Medical Sciences, New Delhi, IND
| | | | - Siddharth Sarkar
- Psychiatry, All India Institute of Medical Sciences, New Delhi, IND
| | - Tanveer Kaur
- Psychology, All India Institute of Medical Sciences, New Delhi, IND
| | - Anamika Sahu
- Psychiatry, All India Institute of Medical Sciences, New Delhi, IND
| | - Upendra Baitha
- Internal Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Avinash Chakrawarty
- Internal Medicine • Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Arvind Kumar
- Internal Medicine, All India Institute of Medical Sciences, New Delhi, IND
| |
Collapse
|
9
|
Baitha U, Ranjan P, Deb KS, Bauddh NK, Singh V, Kaloiya G, Kumar A, Sahu A. Association of Somatic Symptom Severity With Sociodemographic Parameters In Patients With Medically Unexplained Physical Symptoms: A Cross-Sectional Study From a Tertiary Care Center in India. Cureus 2020; 12:e9250. [PMID: 32821596 PMCID: PMC7430686 DOI: 10.7759/cureus.9250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background There is a paucity of studies assessing the severity of somatic symptoms in medically unexplained physical symptoms (MUPS) from Medicine outpatient department (OPD). Methodology This cross-sectional study was conducted in Medicine OPD of a tertiary care hospital in India, in which 245 MUPS-diagnosed patients out of 976 consecutive screened patients were evaluated for the severity of somatic symptoms (by administering the Patient Health Questionnaire-15) and its sociodemographic correlates. Results Out of 245 recruited patients, three-fourth had a significant severity level of somatic symptoms. High level of somatic symptom severity was more common in females (p ≤ 0.001), married patients (p = 0.011), rural dwellers (p = 0.035), less educated (p = 0.003), and those with lower socioeconomic status (p = 0.001). Conclusions Patients with MUPS have a high level of somatic symptom severity with certain sociodemographic correlates. Further research should be conducted to investigate the reasons for this and to formulate a cost-effective treatment strategy.
Collapse
Affiliation(s)
- Upendra Baitha
- Medicine, All India Institute of Medical Sciences, Delhi, IND
| | - Piyush Ranjan
- Medicine, All India Institute of Medical Sciences, Delhi, IND
| | | | | | - Vishwajeet Singh
- Biostatistics, All India Institute of Medical Sciences, Delhi, IND
| | | | - Arvind Kumar
- Medicine, All India Institute of Medical Sciences, Delhi, IND
| | - Anamika Sahu
- Psychiatry, All India Institute of Medical Sciences, Delhi, IND
| |
Collapse
|