OBJECTIVES: Our objectives were to determine how patients who make frequent use of the medical system (high users) with medically unexplained symptoms met our chart-rating criteria for somatization and minor acute illness and what the stability of such diagnoses were over time. STUDY DESIGN: A chart review was performed at baseline and 1 and 2 years; we re-rated the charts of patients initially rated as having somatization, as well as a 15% sample of those with minor acute illness. POPULATION: We obtained a random sample of high-use patients (= 6 visits/year) aged 21 to 55 years who were identified from the management information system. OUTCOMES: We measured chart review designations as organic disease, somatization, or minor acute illness. RESULTS: Among 883 high users at baseline, 35% had organic diseases; 14% had somatization; and 51% had minor acute illness as their primary problems. No patients with initial minor acute diagnoses were reclassified as having somatization 1 or 2 years later, and all but 2 patients had minor acute illness in 1 or both follow-up years. CONCLUSIONS: Minor acute illness was more common among high users than somatization and organic diseases combined. It has not previously been studied but probably has been recognized by clinicians as the "worried well." Diagnoses of somatization were unstable over 2 years follow-up, while minor acute diagnoses were stable, supporting the latter as a valid entity.
OBJECTIVES: Our objectives were to determine how patients who make frequent use of the medical system (high users) with medically unexplained symptoms met our chart-rating criteria for somatization and minor acute illness and what the stability of such diagnoses were over time. STUDY DESIGN: A chart review was performed at baseline and 1 and 2 years; we re-rated the charts of patients initially rated as having somatization, as well as a 15% sample of those with minor acute illness. POPULATION: We obtained a random sample of high-use patients (= 6 visits/year) aged 21 to 55 years who were identified from the management information system. OUTCOMES: We measured chart review designations as organic disease, somatization, or minor acute illness. RESULTS: Among 883 high users at baseline, 35% had organic diseases; 14% had somatization; and 51% had minor acute illness as their primary problems. No patients with initial minor acute diagnoses were reclassified as having somatization 1 or 2 years later, and all but 2 patients had minor acute illness in 1 or both follow-up years. CONCLUSIONS: Minor acute illness was more common among high users than somatization and organic diseases combined. It has not previously been studied but probably has been recognized by clinicians as the "worried well." Diagnoses of somatization were unstable over 2 years follow-up, while minor acute diagnoses were stable, supporting the latter as a valid entity.
Authors: Robert C Smith; Elie Korban; Mohammed Kanj; Robert Haddad; Judith S Lyles; Catherine Lein; Joseph C Gardiner; Annemarie Hodges; Francesca C Dwamena; John Coffey; Clare Collins Journal: Psychother Psychosom Date: 2004 Jan-Feb Impact factor: 17.659
Authors: Robert C Smith; Joseph C Gardiner; Judith S Lyles; Corina Sirbu; Francesca C Dwamena; Annemarie Hodges; Clare Collins; Catherine Lein; C William Given; Barbara Given; John Goddeeris Journal: Psychosom Med Date: 2005 Jan-Feb Impact factor: 4.312
Authors: Azucena Maribel Rodriguez González; José Manuel Ramírez Aranda; Homero de Los Santos Reséndiz; María Yolanda Lara Duarte; Santiago Oscar Pazaran Zanella; Jafet Felipe Méndez López; Issa Gil Alfaro; Félix Gilberto Islas Ruz; Gloria Navarrete Floriano; Edith Guillen Salomón; Obdulia Texon Fernández; Silvia Cruz Duarte; Juan Carlos Romo Salazar; Claudia Elsa Pérez Ruiz; Sara de Jesús López Salas; Lizbeth Benítez Amaya; Javier Nahum Zapata Gallardo Journal: Colomb Med (Cali) Date: 2016-09-30