Abstract
Purpose
Medically unexplained symptoms (MUS) currently constitute the main diagnostic criterion of somatoform disorders. It has been
proposed that the required dichotomization of somatic complaints into MUS and medically explained symptoms (MES) should be
abandoned in DSM-V. The present study investigated complaints in the general population in order to evaluate the relevance
of a distinction between MUS and MES.
proposed that the required dichotomization of somatic complaints into MUS and medically explained symptoms (MES) should be
abandoned in DSM-V. The present study investigated complaints in the general population in order to evaluate the relevance
of a distinction between MUS and MES.
Methods
Three hundred twenty-one participants from a population-based sample were interviewed by telephone to assess symptoms present
during the previous 12 months. Complaints were examined in terms of health care use, diagnoses made by the physician and degree
of impairment. At the 1-year follow-up, 244 subjects were re-interviewed in order to explore the stability of symptoms.
during the previous 12 months. Complaints were examined in terms of health care use, diagnoses made by the physician and degree
of impairment. At the 1-year follow-up, 244 subjects were re-interviewed in order to explore the stability of symptoms.
Results
The complaints frequently prompted participants to seek medical health care (several pain and pseudoneurological symptoms
led to a doctors’ visit in >80 % of cases), although etiological findings rarely suggested a medical pathology (occasionally
<30 %). MUS and MES proved, to an equal degree, to impair individuals and prompt a change in lifestyle. Pain caused the worst
impairment compared with other symptoms. The most prevalent MUS and MES were characterized by a transient course (approximately
60 % remitted, 55 % newly emerged to follow-up), although various unexplained pain complaints tended to be persistent (e.g.,
back pain 67 %). Remarkably, the appraised etiology as explained or unexplained changed from baseline to follow-up in many
persisting symptoms (20 % MUS → MES, 50 % MES → MUS).
led to a doctors’ visit in >80 % of cases), although etiological findings rarely suggested a medical pathology (occasionally
<30 %). MUS and MES proved, to an equal degree, to impair individuals and prompt a change in lifestyle. Pain caused the worst
impairment compared with other symptoms. The most prevalent MUS and MES were characterized by a transient course (approximately
60 % remitted, 55 % newly emerged to follow-up), although various unexplained pain complaints tended to be persistent (e.g.,
back pain 67 %). Remarkably, the appraised etiology as explained or unexplained changed from baseline to follow-up in many
persisting symptoms (20 % MUS → MES, 50 % MES → MUS).
- Content Type Journal Article
- Pages 1-11
- DOI 10.1007/s12529-012-9245-2
- Authors
- Kristina Klaus, Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
- Winfried Rief, Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
- Elmar Brähler, Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
- Alexandra Martin, Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
- Heide Glaesmer, Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany
- Ricarda Mewes, Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
- Journal International Journal of Behavioral Medicine
- Online ISSN 1532-7558
- Print ISSN 1070-5503