Document Detail

Medical symptoms without identified pathology: relationship to psychiatric disorders, childhood and adult trauma, and personality traits.
MedLine Citation:
PMID:  11346329     Owner:  NLM     Status:  MEDLINE    
Community studies have shown that stressful life events, psychological distress, and depressive and anxiety disorders are associated with 1) a range of medical symptoms without identified pathology, 2) increased health care utilization, and 3) increased costs. In both primary care and medical specialty samples, patients who have syndromes with ill-defined pathologic mechanisms (such as the irritable bowel syndrome and fibromyalgia) have been shown to have significantly higher rates of anxiety and depressive disorders than do patients with comparable, well-defined medical diseases and similar symptoms. Other studies show that after adjustment for severity of medical illness, patients with depression or anxiety and comorbid medical disease have significantly more medical symptoms without identified pathology than do patients with a similar medical disease alone. Both childhood maltreatment and psychological trauma in adulthood have been associated with increased vulnerability to psychiatric illness and more medical symptoms. The substantial functional impairment, distress, and costs associated with medical symptoms without identified pathology suggest that research studies promoting a better understanding of the biopsychosocial cause of these symptoms may yield pragmatic, cost-effective approaches to treatment in medical settings.
W Katon; M Sullivan; E Walker
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  134     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-10     Completed Date:  2001-05-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  917-25     Citation Subset:  AIM; IM    
Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, 1959 NE Pacific Street, Seattle, WA 98195-6560, USA.
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MeSH Terms
Anxiety Disorders / psychology
Child Abuse / psychology*
Delivery of Health Care / economics,  utilization
Depressive Disorder / psychology
Health Care Costs
Mental Disorders / psychology*
Severity of Illness Index
Somatoform Disorders / psychology*
Stress, Psychological
Wounds and Injuries / psychology*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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