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Psychiatric Aspects of Medically Unexplained Symptoms

Year 2013, Volume: 5 Issue: 4, 479 - 506, 01.12.2013
https://doi.org/10.5455/cap.20130530

Abstract

The patients with medically unexplained symptoms for their physical symp-toms are generally prevalent in the primary care consultation. Such patient, frequently consume primary and secondary healthcare services and it is a situa-tion that disappointed medical stuff and also patients are uncomfortable for medical services. Physical symptoms commonly are regarded as products of emotional and social problems between different cultural groups and over the world. Generally, depression and anxiety and other psychiatric conditions accompany to patient group with medically unexplained symptoms. The aim of this review article is to investigate the relationship between medically unex-plained symptoms and psychiatric symptoms.

References

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  • Carson AL, Brigitte R, Stone J. Do medically unexplained symptoms matter? a prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry 2000; 68:207-210.
  • Katon W, Sullivan M, Walker E. Medical symptoms without identified pathology: relationship to psychiatry disorders, childhood and adult trauma and personality traits. Ann Intern Med 2001; 134: 917-925.
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  • Escobar JI, Canino G, Rubio-Stipec M, Bravo M. Somatic symptoms after a natural disaster: a prospective study. Am J Psychiatry 1992; 149: 965-967.
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  • Reid S, Wessely S, Crayford T, Hotopf M. Medically unexplained symptoms in frequent attenders of secondary health care: a retrospective cohort study. BMJ 2001; 322:1Bridges KW, Goldberg DP. Somatic presentation of DSM III psychiatric disorders in primary care. J Psychosom Res 1985; 29:563-569.
  • Feder A, Olfson M, Gameroff M, Fuentes M, Shea S, Lantıgua RA. Medically unexplained symptoms in an urban general medicine practice. Psychosomatics 2001; 42:261-268.
  • Schappert SM. National Ambulatory Medical Care Survey: 1989 summary. Vital Healt Stat 1992; 13:1-80.
  • Smith GR, Monson RA, Ray DC. Patients with multiple unexplained symptoms, their characteristics, functional health and health care utilization. Arch Intern Med 1986; 146:69-72.
  • Kroenke K, Arrington ME, Mangelsdorf AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med 1990; 150:1685- 1689.
  • Allan T. Somatizasyonda biyolojik etkenler.Türkiye Klinikleri Psikiyatri Dergisi 1999; 1:18-26.
  • Kellner R. Psychosomatic Syndromes and Somatic Symptoms. Washington DC, American Psychiatric Press,1991.
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  • Koptagel-İlal G. Somatizasyonu nasıl anlamalıyız?-psikodinamik değerlendirmeTürkiye Klinikleri Psikiyatri Dergisi1999; 1:27-33.
  • Hotopf M, Mayou R, Wadsworth M, Wessely S.Childhood risk factors for adults with medically unexplained symptoms: results from a national birth cohort study. Am J Psychiatry 1999; 156:1796-1800.
  • Hotopf M, Wilson-Jones C, Mayou R. Childhood predictors of adult medically unexplained hospitalizations. Br J Psychiatry 2000; 176:273-280.
  • Taylor RE, Mann AH, White NJ. Attachment style in patients with unexplained physical complaints. Psychol Med 2000; 30:931-941.
  • Ruso J, Katon W, Sullivan M. Severity of somatization and its relationship to psychiatric disorders and personality. Psychosomatics 1994; 35:546-556.
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Tıbben Açıklanamayan Belirtilerin Psikiyatrik Yönü

Year 2013, Volume: 5 Issue: 4, 479 - 506, 01.12.2013
https://doi.org/10.5455/cap.20130530

Abstract

Bedensel belirtileri için tıbbi açıklama bulunamayan hastalar genel tıp uygu-lamasında oldukça yaygındırlar. Bu hastalar, tüm sağlık hizmeti basmaklarını sıkça kullanırlar. Bu durum kendilerine sağlık hizmeti sunan hekimlerinde hayal kırıklığı yarattığı gibi hastalar da aldıkları tıbbi bakımdan pek memnun olmazlar. Tüm dünyada ve farklı kültürel gruplar arasında bedensel belirtiler toplumsal sorunların ve duygusal sıkıntının en yaygın bireysel ifadeleridir. Tıbben açıklanamayan belirtilere hasta grubunda depresyon ve anksiyete başta olmak üzere diğer psikiyatrik durumlar eşlik etmektedir. Bu gözden geçirme yazısında tıbben açıklanamayan belirtilere ve psikiyatrik belirtiler arasındaki ilişki incelenmesi amaçlanmıştır

References

  • Ralph DR, Charles CE. Evaluation and management of medically unexplained physical symptoms. Neurologist 2004; 10:18-30.
  • Carson AL, Brigitte R, Stone J. Do medically unexplained symptoms matter? a prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry 2000; 68:207-210.
  • Katon W, Sullivan M, Walker E. Medical symptoms without identified pathology: relationship to psychiatry disorders, childhood and adult trauma and personality traits. Ann Intern Med 2001; 134: 917-925.
  • Hahn SR, Thomson KS, Wills TA. The difficult doctor-patient relationship: somatization, personality and psychopathology. J Clin Epidemiol 1994; 47:647-657. Lin EH, Katon W, Von Korff M, Bush T, Lipscomb P, Russo J. Frustrating patients: physician and patient perspectives among distressed high users of medical services. J Gen Intern Med 1991; 6:241-246.
  • Walker EA, Katon WJ, Keegan D. Predictors of physician frustration in the care of patients with rheumatological complaints. Gen Hosp Psychiatry 1997; 19:315-323. Lipowski ZJ. Somatization: the concept and its clinical application. Am J Psychiatry 1988; 145:1358-1368.
  • Kirmayer LJ, Robbins JM, Paris J. Somatoform disorders: personality and the social matrix of somatic distress. J Abnorm Psychol 1994; 103:125-136.
  • Kirmayer LJ, Taillefer S. Somatoform disorders. In Adult Psychopathology, 2nd edition (Eds. M Hersen, S Turer):333-383. New York, Wiley, 1994.
  • Özen ME, Serhadlı ANZ, Türkcan AS, Ülker GE. Depresyon ve anksiyete bozukluklarında somatizasyon. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2010; 23:60-65.
  • Wilkie A, Wessely S. Patients with medically unexplained symptoms. Br J Hosp Med 1994; 51:421-427.
  • Amerikan Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Washington DC, American Psychiatric Press, 19 Dünya Sağlık Örgütü. Ruhsal ve Davranışsal Bozukluklar Sınıflandırılması. Ankara, Türkiye Sinir ve Ruh Sağlığı Derneği Yayını, 1993.
  • Jablensky A. A comment on the mind-body problem in psychiatry. In Somatoform Disorders: A World-wide Perspective (Eds Y One, A Janca, M Asai, N Sartorius):3 Tokyo. Springer-Verlag, 1999.
  • Katon W, Walker EA. Medically unexplained symptoms in primary care. J Clin Psychiatry 1998; 59:15-21.
  • Ford CV, Folks DG. Conversion disorders: an overview. Psychosomatics 1985; 26:371- 383.
  • Sharpe M, Carson A. "Unexplained" somatic symptoms, functional syndromes, and somatization: do we need a paradigm shift? Ann Intern Med 2001; 134:926-930.
  • Kellner R. Somatization: theories and research. J Nerv Ment Dis 1990; 178:150-160. Katon W, Ries RK, Kleinman A. A prospective DSM-III study of 100 consecutive somatization patients. Compr Psychiatry 1984; 25:305-314.
  • Bridges KW, Goldberg DP, Evans B, Sharpe T. Determinants of somatization in primary care. J Psychosom Res 1991; 29:563-569.
  • Kirmayer RJ, Robbins JM. Three forms of somatization in primary care: prevalence, cooccurrence and sociodemographic characteristics. J Nerv Ment Dis 1991; 179:6476
  • Kellner R. Functional somatic symptoms and hypochondriasis. Arch Gen Psychiatry 1985; 42:821-833.
  • Escobar JI, Canino G, Rubio-Stipec M, Bravo M. Somatic symptoms after a natural disaster: a prospective study. Am J Psychiatry 1992; 149: 965-967.
  • Richardson RD, Engel CC. Evaluation and management of medically unexplained physical symptoms. Neurologist 2004; 10:18-30.
  • Tschudi-Madsen H, Kjeldsberg M, Natvig B, Ihlebaek C, Dalen I, Straand J et al. Multiple symptoms and medically unexplained symptoms: closely related concepts in general practitioners' evaluations. A linked doctor-patient study. J Psychosom Res 2013; 74:186-190.
  • Kroenke K, Spitzer RL, Williams JB, Linzer M, Hahn SR, deGruy FV 3rd et al. Physical symptoms in primary care: predictors of psychiatric disorders and functional impairment. Arch Fam Med 1994; 3:774-779.
  • Kroenke K, Spitzer RL, de Gruy FV, Hahn SR, Linzer M. Multisomatoform disorder: an alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Arch Gen Psychiatry 1997; 54:352-358.
  • Kroenke K, Mangelsdorff AD. Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome. Am J Med 1989; 86:262-266.
  • Hamilton J, Campos R, Creed F. Anxiety, depression and the management of medically unexplained symptoms in medical clinics. J R Coll Physicians 1996; 30:18
  • Carson AJ, Ringbauer B, Stone J, Sharpe M. Do medically unexplained symptoms matter? a prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry 2000; 68:207-210.
  • Reid S, Wessely S, Crayford T, Hotopf M. Medically unexplained symptoms in frequent attenders of secondary health care: a retrospective cohort study. BMJ 2001; 322:1Bridges KW, Goldberg DP. Somatic presentation of DSM III psychiatric disorders in primary care. J Psychosom Res 1985; 29:563-569.
  • Feder A, Olfson M, Gameroff M, Fuentes M, Shea S, Lantıgua RA. Medically unexplained symptoms in an urban general medicine practice. Psychosomatics 2001; 42:261-268.
  • Schappert SM. National Ambulatory Medical Care Survey: 1989 summary. Vital Healt Stat 1992; 13:1-80.
  • Smith GR, Monson RA, Ray DC. Patients with multiple unexplained symptoms, their characteristics, functional health and health care utilization. Arch Intern Med 1986; 146:69-72.
  • Kroenke K, Arrington ME, Mangelsdorf AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med 1990; 150:1685- 1689.
  • Allan T. Somatizasyonda biyolojik etkenler.Türkiye Klinikleri Psikiyatri Dergisi 1999; 1:18-26.
  • Kellner R. Psychosomatic Syndromes and Somatic Symptoms. Washington DC, American Psychiatric Press,1991.
  • Ford CV. The somatizing disorders. Psychosomatics 1986; 27:327-337.
  • Rogers MP, Weinshenker N, Warshaw MG. Prevalence of somatoform disorders in a large sample of patients with anxiety disorders. Psychosomatics 1996; 37:17-22.
  • Koptagel-İlal G. Somatizasyonu nasıl anlamalıyız?-psikodinamik değerlendirmeTürkiye Klinikleri Psikiyatri Dergisi1999; 1:27-33.
  • Hotopf M, Mayou R, Wadsworth M, Wessely S.Childhood risk factors for adults with medically unexplained symptoms: results from a national birth cohort study. Am J Psychiatry 1999; 156:1796-1800.
  • Hotopf M, Wilson-Jones C, Mayou R. Childhood predictors of adult medically unexplained hospitalizations. Br J Psychiatry 2000; 176:273-280.
  • Taylor RE, Mann AH, White NJ. Attachment style in patients with unexplained physical complaints. Psychol Med 2000; 30:931-941.
  • Ruso J, Katon W, Sullivan M. Severity of somatization and its relationship to psychiatric disorders and personality. Psychosomatics 1994; 35:546-556.
  • Güleç YM, Hocaoğlu Ç,Gökçe M, Sayar K. Kalple ilişkili olmayan göğüs ağrısında aleksitimi, öfke ve bedensel duyumları büyütme. Anadolu Psikiyatri Dergisi 2007; 8:14Lipowski ZJ. Somatization: medicine's unsolved problem. Psychosomatics 1987; 28:294-295.
  • Fisch RZ. Masked depression: its interrelations, and conversion. Int J Psychiatry Med 1987; 17:367-369.
  • Escobar JI, Interian A, Díaz-Martínez A, Gara M. Idiopathic physical symptoms: a common manifestation of psychiatric disorders in primary care. CNS Spectr 2006; 11:201-210.
  • Sharpe M, Bass C. Pathophysiological mechanism in somatization. Int Rev Psychiatry 1992; 4: 81-97.
  • Lipowski ZJ. Somatization: a borderland between medicine and psychiatry. CMAJ 1986; 135:609-614.
  • Smith RC. A clinical approach to the somatizing patient. J Fam Pract 1985; 4:29430
  • Oxman TE, Rosenberg SD, Schnurr PP, Tucher GJ. Linguistic dimensions of affect and thought in somatization disorders. Am J Psychiatry 1985; 142:1150-1155.
  • Özen Ş, Özçetin A, Özkan M, Özbulut Ö, Başak İ. Bedenselleştiren hastalarda eksen 2 bozuklukları, kişilik özelikleri ve aleksitimi. Türkiye'de Psikiyatri 1999; 2:114-122. Kooiman CG. The status of alexithymia as a risk factor in medically unexplained physical symptoms. Compr Psychiatry 1998; 39:152-159.
  • Taylor GJ. Recent development in alexithymia theory and research. Can J Psychiatry 2001; 45:134-142.
  • Blanchard EB, Arena JG, Pallmeyer TP. Psychometric properties of a scale to measure alexithymia. Psychother Psychosom 1981; 35:64-71.
  • Özen ME, Türkcan AS, Belene A, Yeşilbursa D, Yurt E. somatizasyonda kültürel ve sosyolojik faktörler. Yeni Symposium 2009; 47:187-193.
  • Lane RD, Sechrest L, Riedel R. Sociodemographic correlates of alexithymia. Compr Psychiatry 1988; 39:377-385.
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Details

Primary Language Turkish
Journal Section Review
Authors

Gökhan Kandemir This is me

İsmail Ak This is me

Publication Date December 1, 2013
Published in Issue Year 2013 Volume: 5 Issue: 4

Cite

AMA Kandemir G, Ak İ. Tıbben Açıklanamayan Belirtilerin Psikiyatrik Yönü. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. December 2013;5(4):479-506. doi:10.5455/cap.20130530

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