The iatrogenic power of labeling medically unexplained symptoms: A critical review and meta-analysis of “diagnosis threat” in mild head injury.

2020 ◽  
Author(s):  
Isabella J. M. Niesten ◽  
Harald Merckelbach ◽  
Brechje Dandachi-FitzGerald ◽  
Marko Jelicic
Keyword(s):  
Head Injury ◽  
Critical Review ◽  
Meta Analysis ◽  
Medically Unexplained Symptoms ◽  
Mild Head Injury ◽  
Diagnosis Threat ◽  
Medically Unexplained ◽  
Unexplained Symptoms

scholarly journals CBT to reduce healthcare use for medically unexplained symptoms: systematic review and meta-analysis

2019 ◽  
Vol 69 (681) ◽  
pp. e262-e269 ◽  
Author(s):  
Brittni Jones ◽  
Amanda C de C Williams
Keyword(s):  
Systematic Review ◽  
Healthcare Costs ◽  
Meta Analysis ◽  
Medically Unexplained Symptoms ◽  
Psychological Interventions ◽  
Healthcare Use ◽  
Cognitive Behavioural ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Medical Investigations

BackgroundStudies have reported that medically unexplained symptoms (MUS) tend to be associated with increased healthcare use, which is demanding of resources and potentially harmful to patients. This association is often used to justify the funding and study of psychological interventions for MUS, yet no systematic review has specifically examined the efficacy of psychological interventions in reducing healthcare use.AimTo conduct a systematic review and meta-analysis to evaluate the effectiveness of cognitive behavioural therapies (CBT) for MUS in reducing healthcare use.Design and settingSystematic review and meta-analysis.MethodThe search from a previous systematic review was updated and expanded. Twenty-two randomised controlled trials reported healthcare use, of which 18 provided data for meta-analysis. Outcomes were healthcare contacts, healthcare costs, medication, and medical investigations.ResultsSmall reductions in healthcare contacts and medication use were found for CBT compared with active controls, treatment as usual, and waiting list controls, but not for medical investigations or healthcare costs.ConclusionCognitive behavioural interventions show weak benefits in reducing healthcare use in people with MUS. The imprecise use of MUS as a diagnostic label may impact on the effectiveness of interventions, and it is likely that the diversity and complexity of these difficulties may necessitate a more targeted approach.

12 Self-help for medically unexplained symptoms: a systematic review and meta-analysis

2017 ◽  
Vol 88 (8) ◽  
pp. A32.1-A32
Author(s):  
Anne van Gils ◽  
Robert A Schoevers ◽  
Irma J Bonvanie ◽  
Jeannette M Gelauff ◽  
Annelieke M Roest ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Medically Unexplained Symptoms ◽  
Self Help ◽  
Medically Unexplained ◽  
Unexplained Symptoms

scholarly journals Using the common-sense model to understand health outcomes for medically unexplained symptoms: a meta-analysis

2018 ◽  
Vol 13 (4) ◽  
pp. 427-446 ◽  
Author(s):  
Lisa M. McAndrew ◽  
Marcus Crede ◽  
Kieran Maestro ◽  
Sarah Slotkin ◽  
Justin Kimber ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Common Sense ◽  
Meta Analysis ◽  
Medically Unexplained Symptoms ◽  
Common Sense Model ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
The Common ◽  
Sense Model

scholarly journals What Works in Mindfulness Interventions for Medically Unexplained Symptoms? A Systematic Review

2020 ◽  
Vol 5 (1) ◽  
pp. 21-34
Author(s):  
Ruel Billones ◽  
Nada Lukkahatai ◽  
Leorey Saligan
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Medically Unexplained Symptoms ◽  
Mindfulness Practice ◽  
General Effect ◽  
Home Based ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Mindfulness Interventions ◽  
The Moment

Background/Purpose: Mindfulness-based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines (PRISMA) and the modified Oxford Quality Scoring System (Jadad score) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or Fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. Results/Conclusions: MBIs showed large effects on: symptom severity (d = 0.82), pain intensity (d =0.79), depression (d = 0.62), and anxiety (d = 0.67). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the nonjudgmental observance of the experience in the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.

scholarly journals Prevalence of medically unexplained symptoms in adults who are high users of health care services: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027922 ◽  
Author(s):  
Ferozkhan Jadhakhan ◽  
Oana C Lindner ◽  
Amy Blakemore ◽  
Elspeth Guthrie
Keyword(s):  
Systematic Review ◽  
Healthcare Costs ◽  
Meta Analysis ◽  
Medically Unexplained Symptoms ◽  
Cochrane Library ◽  
Persistent Symptoms ◽  
Study Results ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
The Cochrane Library

IntroductionMedically unexplained symptoms (MUS) are common in primary-care and secondary-care settings. Persistent symptoms of MUS are associated with a variety of poor outcomes including increased disability, poor quality of life and high healthcare costs. The aim of this systematic review is to review the relevant literature to determine the prevalence of MUS in patients who are high users of healthcare and/or who accrue high healthcare costs.Methods and analysisThis review will include studies with cases that are either high users of general healthcare or are patients who accrue high healthcare costs, aged ≥18 years and where a recognised measure of MUS, either a standardised clinical interview or questionnaire, was employed. The following citation databases MEDLINE, PsycINFO, EMBASE, CINAHL, PROSPERO and the Cochrane library will be systematically searched from inception to 30 June 2018. The Cochrane library was included because of the significant proportion of non-observational studies currently published in the database. The prevalence of MUS and associated disorders along with the costs or use of healthcare associated with the presence of MUS will be estimated with 95% CI. If possible, study results will be pooled into a meta-analysis. However, if heterogeneity is high, data analysis will be presented descriptively.Ethics and disseminationEthical approval is not required for this systematic review since only data from existing studies will be used. Results of this review will be disseminated in peer-reviewed publications and at national and international conferences.PROSPERO registration numberCRD42018100388

scholarly journals Does It Matter Who Provides Psychological Interventions for Medically Unexplained Symptoms? A Meta-Analysis

2015 ◽  
Vol 84 (4) ◽  
pp. 217-226 ◽  
Author(s):  
Heike Gerger ◽  
Michaela Hlavica ◽  
Jens Gaab ◽  
Thomas Munder ◽  
Jürgen Barth
Keyword(s):  
Meta Analysis ◽  
Medically Unexplained Symptoms ◽  
Psychological Interventions ◽  
Medically Unexplained ◽  
Unexplained Symptoms
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