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medically Unexplained Symptoms (MUS): What Do Current Trainee Psychologists, Neurologists and Psychiatrists Believe?

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Open Journal of Medical Psychology 2013年第1期2卷 12-20页

作者： Steven Kemp Catherine Spilling Christine Hughes Karel de Pauw St James’s University Hospital Leeds UK

Objectives: medically unexplained symptoms (MUS) are common in all medical settings. These conditions remain controversial, aetiology remains poorly understood and treatments have been slow to develop. This study aimed to examine the beliefs held by psychologists and other professionals about MUS, which may impact upon clinical practice. Design: 375 clinical psychology trainees from 23UKtraining courses, 12 neurologists and 19 psychiatrists in training completed a weblink survey designed to elicit a range of beliefs about MUS cause and treatment. Results: All three groups viewed MUS as a common clinical problem. Use of terminology differed between groups. All three groups held a view that sexual abuse was a medium to high risk factor for developing MUS. Only a minority of psychologists and psychiatrists doubted that the human mind is capable of massive repression for past distressing events;and few psychologists, and no psychiatrists, doubted the traditional psychodynamic causal model of MUS. Neurologists were generally more skeptical. Only a minority of all three groups disagreed that hypnosis was a helpful way to uncover memories that people can not access. Around one third of each group believed that traumatic memories recovered in therapy were reliable. Dualistic thinking was prevalent among all three groups, but more so among psychiatrists. Conclusions: The data show that many professsionals hold beliefs about MUS for which, empirical support is lacking. These beliefs may impact on clinical practice. Whether such beliefs are deemed to be correct or incorrect, they should be acknowledged.

关键词： medically Unexplained Symptoms Somatisation Dissociation Clinical Training

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Somatization Symptoms in a Primary Care Clinic at a Tertiary Hospital in Southern Nigeria

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Journal of Biosciences and Medicines 2015年第10期3卷 67-73页

作者： Chidi J. Okafor Bassey Edet Udeme Asibong Department of Psychiatry College of Medical Sciences University of Calabar Calabar Nigeria Clinical Services Department Federal Psychiatric Hospital Calabar Calabar Nigeria Department of Family Medicine College of Medical Sciences University of Calabar Calabar Nigeria

Background: Somatic symptoms that are not attributable to organic pathology are common in general practice settings however, data in most parts of Africa including southern Nigeria are still scarce. The aim of our study was to examine such somatic symptoms reported by patients attending a primary care facility at a tertiary hospital in southern Nigeria as well as to motivate future research in this area. Method: The study was conducted at the General Out Patient Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH). It was a cross sectional study in which data were obtained from the case notes of 115 patients that presented in the clinic with somatic complaints which could not be attributed to organic pathology by their physicians. Results: While 46 of the patients were males, 69 were females. Their mean age was 37.7 (SD = 11.9). Internal heat, crawling sensation, body pains and palpitations were the most prevalent symptoms reported by the patients. When the symptoms were sorted into various groups, the “subjective abnormal bodily sensation” was the most prevalent and far outnumbered the “pseudo neurological symptoms”. Conclusion: A number of patients attending the GOPC of the UCTH seek consultations for medically unexplained somatic symptom. The most prevalent of these symptoms are internal heat and crawling sensations both of which are not stated in the criteria recognized by the International Classification of Diseases—version 10 (ICD-10) for the diagnosis of psychiatric disorders.

关键词： Somatization medically Unexplained Somatic Symptom Abnormal Bodily Sensations Southern Nigeria

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Predictors of a poor outcome in patients with symptomatic middle cerebral artery occlusion treated medically

Predictors of a poor outcome in patients with symptomatic mi...

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2018年浙江省神经病学学术年会

作者： Meiping Wang Jinhua Zhang Junpeng Zhu Yuehong Huang Ying Yang Xu You Xiaojun Yin Liping Du Tianming Shi Yiqi Wang Department of Neurology Zhejiang Provincial People's Hospital People's Hospital of Hangzhou Medical Department of Neurology Sir Run Run Shaw Hospital Zhejiang University School of Medicine HangZhou Seventh People's Hospital

Background: The annual risk for recurrent stroke or cardiovascular events is high with symptomatic middle cerebral artery occlusion(MCAO). We investigated the clinical markers for a poor outcome in symptomatic MCAO patients.Methods: Our study had a single-center, retrospective cohort design. Patients who had survived at least 1 month after an initial ischemic stroke or transient ischemic attack(TIA) who had atherosclerotic occlusion of the middle cerebral artery(MCA) were enrolled. The composite outcome included stroke or TIA, myocardial infarction(MI), and death(vascular and nonvascular death). We sought predictors using a logistic model.Results: In all, 101 patients(mean age 57.6±13.3 years, 59.4% male) were enrolled. During a mean follow-up period of 26 months, composite end-point events occurred in 17(16.8%) patients: 14 had recurrent stroke and 7 died to vascular issues(4 recurrent strokes, 2 initial strokes, and 1 MI). A multivariate logistic model showed that old age( ≥ 65 years), hypertension, smoking, and discontinuation of antiplatelet drugs were independent risk factors for a poor outcome in symptomatic MCAO patients. Furthermore, the incidence of a poor outcome in MCAO increased with the number of risk factors.Conclusions: We evaluated the long-term prognosis of symptomatic MCAO patients under current medical management. Old age( ≥ 65 years), hypertension, smoking, and discontinuation of antiplatelet therapy were significant predictors of a poor outcome for symptomatic MCAO. The incidence of a poor outcome increased significantly in symptomatic MCAO patients with two or more of these risk factors.

关键词： symptomatic middle cerebral artery occlusion predictor medically

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