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全科医疗中医学上无法解释的症状持续存在。

Persistent presentation of medically unexplained symptoms in general practice.

作者信息

Verhaak Peter F M, Meijer Susan A, Visser Adriaan P, Wolters Gerrit

机构信息

Netherlands Institute of Health Services Research, PO Box 1568, 3500 BN Utrecht.

出版信息

Fam Pract. 2006 Aug;23(4):414-20. doi: 10.1093/fampra/cml016. Epub 2006 Apr 21.

Abstract

OBJECTIVES

To estimate the prevalence of persistent presentation of medically unexplained physical symptoms (MUPS) in general practice. To assess socio-demographic characteristics, health status and use of health services of patients who frequently present MUPS, compared with reference groups.

DESIGN

One-year, nationwide, representative survey of morbidity in general practice in The Netherlands, including 400,000 enlisted patients in 104 general practices.

RESULTS

Of all patients (age: 18 years and older), 2.45% who visited their GP at least once a year, presented at least 4 times in 1 year with symptoms which are commonly considered medically unexplained without getting a medical diagnosis during that period, that might explain the symptoms. These patients are significantly older, more often female, less educated, more frequently unemployed and more frequently from a non-Western origin than 'average' patients or patients with a medical diagnosis.

CONCLUSION

Although 25-50% of all reasons for visit to a GP concern symptoms that are not medically explained, the frequent presentation of such symptoms is much more rare. Frequent attendance because of MUPS is most common among elderly women with a lower socio-economic status.

摘要

目的

评估全科医疗中持续存在的医学无法解释的身体症状(MUPS)的患病率。与参照组相比,评估频繁出现MUPS的患者的社会人口学特征、健康状况及医疗服务利用情况。

设计

在荷兰进行的为期一年的全国性全科医疗发病率代表性调查,包括104家全科诊所的40万名登记患者。

结果

在所有每年至少看一次全科医生的患者(年龄18岁及以上)中,2.45%的患者在1年内至少4次出现通常被认为是医学无法解释的症状,且在此期间未得到能解释这些症状的医学诊断。与“普通”患者或有医学诊断的患者相比,这些患者年龄更大、女性更多、受教育程度更低、失业更频繁且更多来自非西方背景。

结论

虽然全科医生就诊原因中有25%-50%涉及医学无法解释的症状,但频繁出现此类症状的情况要罕见得多。因MUPS频繁就诊在社会经济地位较低的老年女性中最为常见。

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