Patients with “Organically Unexplained Symptoms” Presenting to a Borreliosis Clinic: Clinical and Psychobehavioral Characteristics and Quality of Life

Abstract

This study explores the prevalence of patients with "organically unexplained symptoms" presenting to a Lyme borreliosis clinic and describes their clinical and psychobehavioral characteristics as well as health-related quality of life. Study instruments consisted of a set of self-rating questionnaires and an organicity rating of presenting symptoms by an acknowledged expert. Participants included 125 patients presenting with symptoms attributed to borreliosis. Clinical and psychobehavioral characteristics as well as health-related quality of life for patients whose symptoms were rated as "organically unexplained" were compared with those of patients whose symptoms were rated as "organically explained." Symptoms of 37 (30%) patients were rated as "organically unexplained" (ORG-) and symptoms of 88 (70%) patients were rated as "organically explained" (ORG+). ORG- differed from ORG+ in various clinical and psychobehavioral characteristics and in health-related quality of life. For example, ORG- reported a higher number of symptoms, more illness consequences and negative emotional illness representations, and felt less reassured in the medical context, more dissatisfied with medical care, and more convinced of having a serious illness. Our results suggest that patients with "organically unexplained symptoms" inadequately attributed to Lyme borreliosis reveal many clinical and psychobehavioral characteristics that indicate significant somatic and mental distress. An early focus on all of the patients' mental and bodily symptoms, as well as on subjective illness perceptions and consequences allows for a more specific plan.