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Minerva Psichiatrica 2019 September;60(3):114-23

DOI: 10.23736/S0391-1772.19.02016-8


lingua: Inglese

Clinical variables and costs related to healthcare management in patients with somatic symptoms disorder: a retrospective study

Ivano CASELLI 1, Nicola POLONI 1, Marta IELMINI 1, Michele MATTIA 2, Alessandra DE LEO 1, Marco DI SARNO 3, Alessandro BELLINI 1, Camilla CALLEGARI 1

1 Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy; 2 Family Therapy Center, Lugano, Switzerland; 3 Department of Psychology, University of Milan Bicocca, Milan, Italy

BACKGROUND: Medically unexplained physical symptoms (MUPS) are physical symptoms without a medical explanation. The study provided for the collection of data from hospitalized patients presenting MUPS, aiming to draw a clinical and sociodemographic profile of patients with somatic symptoms disorder (SSD), and to estimate economic costs related to hospital management.
METHODS: This observational retrospective study consisted in the evaluation of data referring to all hospitalized patients admitted between 2008 and 2018 in the wards of a teaching hospital in Northern Italy.
RESULTS: A total of 273 patients presenting with MUPS have been hospitalized. The sample showed a prevalence of female, married, and workers patients. The most frequent ward involved is neurology, followed by internal medicine and Short Stay Unit. The most common symptoms found are headache, pain, syncope and vertigo. No evidence that having a medical disease predict the developing of somatic symptoms disorder emerged. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association also emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for MUPS is € 475,409.73.
CONCLUSIONS: Further investigations are needed to extend the study on other clinical areas and to clarify the correlates.

KEY WORDS: Medically unexplained symptoms; Psychosomatic medicine; Community psychiatry; Health care costs

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