Predictors of Persistent Medically Unexplained Physical Symptoms: Findings From a General Population Study.

Jonna F Van Eck Van Der Sluijs,Harm W J Van Marwijk,Cees A Th Rijnders,Christina M Van Der Feltz-Cornelis,Ron De Graaf,Margreet Ten Have

doi:10.3389/fpsyt.2018.00613

Abstract

Objective: To explore the persistency of Medically Unexplained Symptoms (MUS) and its prognostic factors in the general adult population. Knowledge of prognostic factors of MUS may indicate possible avenues for intervention development.Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face cohort study among the Dutch general population aged 18–64 years. We selected subjects with MUS at baseline and who participated at follow-up (N = 324) and reassessed those subjects for having MUS at 3 year follow-up. Logistic regression analyses were used to determine risk factors for persistency of MUS.Results: 36.4% of the subjects had persistent MUS at follow-up. In logistic regression analyses adjusted for sex and age, persistency of MUS was predicted by the number of comorbid chronic medical disorder(s), lower education, female sex, not having a paid job, parental psychopathology as well as lower functioning. In the logistic regression analysis in which all significant variables adjusted for sex and age were entered simultaneously, three variables predicted persistent MUS: parental psychopathology, the number of comorbid chronic medical disorder(s) and physical functioning, with odds ratios of 2.01 (1.20–3.38), 1.19 (1.01–1.40), and 0.99 (0.97–1.00), respectively.Conclusion: In the adult general population, MUS were persistent in over one third of the subjects with MUS at baseline. Persistency was significantly predicted by parental psychopathology, number of comorbid chronic medical disorders, and physical functioning. These findings warrant further research into early intervention and treatment options for persons with an increased risk of persistent MUS.

Highlights

BackgroundPersons with Medically Unexplained physical Symptoms (MUS) are highly prevalent in health care settings [1], and in the general population [2, 3]
Persistency was significantly predicted by parental psychopathology, number of comorbid chronic medical disorders, and physical functioning
We hypothesize that female sex, childhood trauma, parental psychopathology, presence of negative life events, presence of common mental disorders, number of comorbid chronic medical disorder(s), and worse physical or general functioning–all measured at baselineare associated with persistence of MUS measured at 3-year follow-up. In this general population study, we examine the persistency of MUS and what factors are associated with persistence of MUS, over 3 years

Summary

Introduction

Persons with Medically Unexplained physical Symptoms (MUS) are highly prevalent in health care settings [1], and in the general population [2, 3]. More precise estimates of how many persons with MUS -i.e., in the general population- suffer persistently from MUS, and what factors influence this persistency facilitate resource and care planning and may indicate possible avenues for future intervention development. This is needed, because such interventions can perhaps lead to a more favorable course of MUS and thereby reduce the heavy burden and impairment persons with persistent MUS can experience and they can help to possibly reduce costs

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Conclusion