scholarly journals Epidemiology and organization of care in medically unexplained symptoms: a systematic review with a focus on cultural diversity and migrants

2021 ◽  
Author(s):  
Peter Vermeir ◽  
An Mariman ◽  
Lilla Lucza ◽  
Sallay Viola ◽  
Anne Weiland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cultural Diversity ◽  
Medically Unexplained Symptoms ◽  
Organization Of Care ◽  
Medically Unexplained ◽  
Unexplained Symptoms

scholarly journals Epidemiology and organization of care in medically unexplained symptoms: a systematic review with a focus on cultural diversity and migrants

2021 ◽  
Author(s):  
Peter Vermeir ◽  
An Mariman ◽  
Lilla Lucza ◽  
Sallay Viola ◽  
Anne Weiland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Medically Unexplained Symptoms ◽  
Physical Symptoms ◽  
Somatoform Disorder ◽  
Case Definitions ◽  
Organization Of Care ◽  
Care Models ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background: Since the pathophysiology of medically unexplained symptoms (MUS) remains unclear, health care providers often struggle with these patients, especially with a different ethnic and/or cultural background. These challenges are insufficiently addressed in their training and in the organization of care. Aim: To improve health care provider-patient interaction focused on MUS patients in general and in ethnic minorities and refugees in particular through a systematic review of syndromal definitions and epidemiology and organization of care of MUS patients. Methods: Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords ‘Medical unexplained (physical) symptoms (MUPS)’, ‘Somatoform disorder’, ‘Functional syndrome’, ‘Diversity’, ‘Migrants’, ‘Ethnicity’, ‘Care models’, ‘Medical education’, ‘Communication skills’, ‘Health literacy’ Results: Different case definitions result in markedly different epidemiologic estimates for MUS patients. Nevertheless, they are prevalent in a wide range of health care settings. Literature offers evidence of the effectiveness of structural frameworks in approaching MUS patients. Organization of MUS care needs to transcend different levels of care: specialist tertiary and secondary care and primary care involving different qualifications of caregivers need to be aligned. Conclusion: The systematic review identified significant gaps and shortcomings in organization of care. These need to be addressed in order to improve outcomes. Keywords: Medical unexplained (physical) symptoms (MUPS), Somatoform disorder, Functional syndrome, Diversity, Migrants, Ethnicity, Care models Message for the clinic: - Medically unexplained symptoms are highly prevalent but case definitions hamper both recognition and a proper approach. - MUS are ill understood in both the general population as in migrants and refugees. - Interdisciplinary and integrated care through a biopsychosocial model is mandatory.

scholarly journals Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0205278 ◽  
Author(s):  
Margreet S. H. Wortman ◽  
Joran Lokkerbol ◽  
Johannes C. van der Wouden ◽  
Bart Visser ◽  
Henriëtte E. van der Horst ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Medically Unexplained Symptoms ◽  
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

Medically unexplained symptoms, somatisation disorder and hypochondriasis: Course and prognosis. A systematic review

2009 ◽  
Vol 66 (5) ◽  
pp. 363-377 ◽  
Author(s):  
Tim C. olde Hartman ◽  
Machteld S. Borghuis ◽  
Peter L.B.J. Lucassen ◽  
Floris A. van de Laar ◽  
Anne E. Speckens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medically Unexplained Symptoms ◽  
Somatisation Disorder ◽  
Medically Unexplained ◽  
Unexplained Symptoms

scholarly journals Assessing the Effectiveness of Brief and Low Intensity Psychological Interventions for Medically Unexplained Symptoms and Health Anxiety: A Systematic Review of the Literature

2020 ◽  
Author(s):  
Orla McDevitt-Petrovic ◽  
Karen Kirby
Keyword(s):  
Systematic Review ◽  
Health Anxiety ◽  
Medically Unexplained Symptoms ◽  
Future Research ◽  
Psychological Interventions ◽  
Review Of The Literature ◽  
Illness Anxiety Disorder ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Illness Anxiety

This chapter presents a systematic review of the literature to assess the effectiveness of brief psychological interventions for medically unexplained symptoms (MUS)/somatic symptom disorder, non-cardiac chest pain, and illness anxiety disorder or health anxiety (HA). Google Scholar, PubMed, and Web of Science were searched as data sources. Reference lists were subsequently examined for other relevant articles. Studies were assessed according to specified inclusion criteria and extracted according to PRISMA guidelines. A total of 23 studies were included in the final synthesis. Significant effects for intervention groups relative to control groups were reported in 19 studies, whilst 4 studies did not determine any significant benefits of interventions compared with controls. All of the brief interventions (CBT, psychosocial, psychophysiological, psychosomatic, relaxation and group therapy), with the exception of metaphor therapy, showed significant effects relative to controls in at least one study. The evidence suggests that brief psychological interventions, more specifically time limited CBT based interventions may be effective in treating HA and MUS with psychological distress. Findings are comparable with other reviews. Future research may facilitate the piloting of an intervention, and there remains a need to provide more robust evidence of cost effectiveness.

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