Matheus H L Arts1, Carolien E M Benraad2, Denise Hanssen3, Peter Hilderink4, Linda de Jonge5, Paul Naarding6, Peter Lucassen7, Richard C Oude Voshaar3. 1. University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, the Netherlands; Mental Health Center Westelijk-Noord Brabant, Halsteren, the Netherlands. Electronic address: m.arts@ggzwnb.nl. 2. Department of Geriatric Medicine/Radboudumc Alzheimer Center, Donders Institute for Medical Neurosciences, Radboud University Medical Center, Nijmegen, the Netherlands. 3. University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, the Netherlands. 4. Department of Old Age Psychiatry, SeniorBeter, Gendt, the Netherlands. 5. Mental Health Center Westelijk-Noord Brabant, Halsteren, the Netherlands. 6. Department of Old Age Psychiatry, GGNet, Apeldoorn, the Netherlands. 7. Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
Abstract
OBJECTIVES: To examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES). DESIGN: Cross-sectional, comparative study. SETTING: Community, primary care, and secondary healthcare to recruit patients with MUS in various developmental and severity stages and primary care to recruit patients with MES. PARTICIPANTS: In total, 118 patients with MUS and 154 patients with MES, all aged ≥60 years. METHODS: Frailty was assessed according to the Fried criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson comorbidity index, and the number of prescribed medications. RESULTS: Although patients with MUS had less physical comorbidity compared with patients with MES, they were prescribed the same number of medications. Moreover, patients with MUS were more often frail compared with patients with MES. Among patients with MUS, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation. CONCLUSIONS AND IMPLICATIONS: Despite a lower prevalence of overt somatic diseases, patients with MUS are more frail compared with older patients with MES. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy.
OBJECTIVES: To examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES). DESIGN: Cross-sectional, comparative study. SETTING: Community, primary care, and secondary healthcare to recruit patients with MUS in various developmental and severity stages and primary care to recruit patients with MES. PARTICIPANTS: In total, 118 patients with MUS and 154 patients with MES, all aged ≥60 years. METHODS: Frailty was assessed according to the Fried criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson comorbidity index, and the number of prescribed medications. RESULTS: Although patients with MUS had less physical comorbidity compared with patients with MES, they were prescribed the same number of medications. Moreover, patients with MUS were more often frail compared with patients with MES. Among patients with MUS, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation. CONCLUSIONS AND IMPLICATIONS: Despite a lower prevalence of overt somatic diseases, patients with MUS are more frail compared with older patients with MES. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy.
Authors: Richard C Oude Voshaar; Ton D F Dhondt; Mario Fluiter; Paul Naarding; Sanne Wassink; Maureen M J Smeets; Loeki P R M Pelzers; Astrid Lugtenburg; Martine Veenstra; Radboud M Marijnissen; Gert-Jan Hendriks; Lia A Verlinde; Robert A Schoevers; Rob H S van den Brink Journal: BMC Psychiatry Date: 2019-06-17 Impact factor: 3.630
Authors: Barbara Resnick; Elizabeth Galik; Rachel McPherson; Marie Boltz; Kimberly Van Haitsma; Ann Kolanowski Journal: West J Nurs Res Date: 2021-05-28 Impact factor: 1.774