Caracterización sociodemográfica y clínica psiquiátrica de pacientes con síntomas médicamente inexplicables en una institución prestadora de salud de Medellín (Colombia)

Abstract

IntroductionMedically unexplained symptoms are defined as physical symptoms that have been present for several weeks and that an adequate medical evaluation has not revealed any disease that explains them; when these symptoms become persistent, they lead to comprehensive clinical investigations and multiple interventions. These patients have a greater or at least comparable commitment to physical functioning, mental health, and negative health perception than patients with multiple chronic medical conditions; have significantly more stressful life events (psychological, physical and/or sexual abuse) and are more likely to meet diagnostic criteria for anxiety and depression. ObjectiveTo characterize sociodemographic and psychiatric characteristics of a group of patients identified in primary care with medically unexplained symptoms. MethodologyA descriptive, cross-sectional study with patients from 18 to 70 years old who were given PHQ-15, PHQ-9 and PHQ for anxiety, and a survey designed for the study. Results36 patients were analysed, 94.4% women, median age 45 [RIC, 20] years-old, 33.3% married, 91.7% had children. 55% had severe functional somatic symptoms, 77.8% had one or more functional somatic disorders, and 77.7% had clinically relevant affective or anxiety symptoms. 25% of the patients reported a history of child abuse, 41.7% were mistreated by a partner, and 41.6% were victims of the Colombian armed conflict. ConclusionsThe main finding of this study was that 8 out of 10 patients met criteria for a functional somatic disorder with great symptomatic severity and three out of ten patients met criteria for two functional disorders, most of these patients without other basic medical diseases. In addition, we found a high prevalence of exposure to different types of violence that these patients have been subjected to throughout their life.