Physicians who analyzed medical records from 289 medical clinic patients
concluded that 37 percent of the symptoms noted in the records had an unknown
cause and 10 percent had a psychiatric cause, with the rest of the symptoms
having a physical cause.
The findings suggest that doctors may need better diagnostic strategies
for unexplained symptoms, according to Kurt Kroenke, M.D., and colleagues
at the Indiana University School of Medicine. Their findings appear in
the November issue of Psychosomatics.
“It is likely that some proportion of the patients with unexplained
symptoms in our study had coexisting and potentially treatable mental disorders,” Kroenke
says.
“Developing better management strategies for prevalent, medically
unexplained, persistent … symptoms is a health care priority,” he
adds.
At least a fourth of all symptoms persisted a year after the patient’s
first hospital visit, the researchers found.
Three groups were almost twice as likely to have a persistent symptom:
males and those of both sexes who suffered from common complaints like
headaches or back pain or who had multiple medical problems.
Pain complaints made up nearly half of the symptoms in the records analyzed
by Kroenke and colleagues. Back pain, headache and limb pain were the most
common symptoms. Coughing, trouble breathing and other respiratory complaints
made up the majority of non-pain symptoms.
Black patients, those who were making their first visit to treat a symptom,
and returning patients whose symptoms had improved were more likely to
have symptoms with physical causes, the researchers found.
Those who received medicine or tests were also more likely to have symptoms
with a physical cause.
The researchers found that missed diagnoses — classifying a symptom
as physical when its true cause was psychiatric, for instance — were
rare.
