Somatophorm and Medically Unexplained Symptoms (MUS)

Question 1

What are somatic symptoms not clearly associated with?

Answer 1

Somatic symptoms not clearly associated with physical pathology.

Question 2

In which populations are somatic symptoms common?

Answer 2

Somatic symptoms are common in the general population and in patients in all medical settings.

Question 3

Are somatic symptoms more frequent in women or men?

Answer 3

Somatic symptoms are more frequent in women than in men.

Question 4

Are most somatic symptoms transient or persistent?

Answer 4

Most somatic symptoms are transient asting more than a few weeks.

Question 5

What percentage of somatic symptoms are persistent and disabling?

Answer 5

A minority of somatic symptoms are persistent and disabling.

Question 6

What is a common outcome despite adequate medical investigation in somatic symptoms?

Answer 6

Despite adequate medical investigation no somatic disorder is found to explain the symptoms entirely.

Question 7

What is Somatic Symptom Disorder according to DSM-5?

Answer 7

A diagnostic category characterized by prominent somatic symptoms associated with significant distress and impairment including excessive thoughts

Question 8

How many somatic symptoms are required to characterize Somatic Symptom Disorder?

Answer 8

One or more distressing somatic symptoms causing significant disruption in daily life and excessive thoughts and feelings

Question 9

What are Functional Syndromes?

Answer 9

Conditions where patients often have multiple functional syndromes involving symptoms unexplained by recognized medical conditions across multiple specialties.

Question 10

Name some motor symptoms seen in Conversion Disorder (Functional Neurological Symptom Disorder).

Answer 10

Motor symptoms affecting limbs (weakness and paralysis)

Question 11

What sensory symptoms are seen in Functional Neurological Symptom Disorder?

Answer 11

Loss of sensory functions such as loss of hearing and vision

Question 12

What cognitive changes may occur in Functional Neurological Symptom Disorder?

Answer 12

Changes in cognitive function or consciousness such as foggy thinking or difficulties in concentration.

Question 13

Are motor and sensorial symptoms explained by recognized neurological or medical conditions?

Answer 13

No, motor and sensorial symptoms in functional syndromes are incompatible with recognized neurological or medical conditions; they are medically unexplained.

Question 14

Are psychological factors a mandatory cause for Functional Syndromes?

Answer 14

No, precipitating or persisting psychological factors are not mandatory

Question 15

What distress or impairment is associated with Functional Syndromes?

Answer 15

Significant distress or impairment in social or occupational

Question 16

What is the estimated prevalence of Medically Unexplained Symptoms (MUS) in general practice?

Answer 16

30-50% in general practitioner settings.

Question 17

What specialties have a higher range of MUS prevalence (40-60%)?

Answer 17

Neurology; Rheumatology (examples)

Question 18

What percentage of people had at least one physical symptom in the last 2 weeks?

Answer 18

85-95% of people had at least one physical symptom during the last 2 weeks.

Question 20

What is the prevalence of severe Medically Unexplained Symptoms (MUS)?

Answer 20

Severe MUS prevalence is approximately 2.5%.

Question 21

What biological systems are involved in risk factors for MUS?

Answer 21

The Sympatho-Adrenomedullary System and the Hypothalamic-Pituitary-Adrenal (HPA) Axis

Question 21

How does the gut impact brain function and mental health?

Answer 21

The enteric nervous system produces neurotransmitters such as serotonin and metabolites that influence mental health conditions like stress and anxiety

Question 22

What are some individual impacts of Medically Unexplained Symptoms (MUS)?

Answer 22

Reduced participation; lower quality of life

Question 23

What societal impacts do Medically Unexplained Symptoms (MUS) cause?

Answer 23

Absence from work lower productivity

Question 24

What relationship exists between one MUS and the development of others?

Answer 24

The presence of one MUS strongly predicts the development or coexistence of one or more additional MUS.

Question 25

What psychiatric comorbidities are commonly observed in MUS patients?

Answer 25

Approximately 26% of MUS patients have comorbid anxiety disorders and/or depression; dissociative and personality disorders are also observed.

Question 26

What is the most important factor in the assessment of MUS?

Answer 26

Effective communication by the physician is the most important factor.

Question 27

What should the physician explain to the patient during MUS assessment?

Answer 27

The purpose and results of all investigations and why no medical cause was found

Question 28

Which patient-related factors should be considered during MUS assessment?

Answer 28

The nature and significance of symptoms to the patient previous illness concerns

Question 29

What should be emphasized in basic approaches to managing MUS?

Answer 29

That the symptoms are real and understood by the clinician and the role of psychosocial factors in medical conditions should be explained.

Question 30

What treatment elements should be included in a MUS management plan?

Answer 30

Treatment of minor medical problems associated psychiatric disorders

Question 31

If reassurance is insufficient for MUS patients what should clinicians do?

Answer 31

Seek repeated investigation and reassurance while explaining why further investigation is unnecessary emphasizing the influence of both psychological and biological factors.

Question 32

Who provides the basis for psychological management in MUS?

Answer 32

Primary care physicians and psychiatrists

Question 33

What treatments may be used specifically for MUS symptoms?

Answer 33

Antidepressants and hypnotics

Question 34

Is there a solid prevention method for MUS?

Answer 34

No solid prevention basis exists but reducing predisposing factors like childhood abuse

Question 35

What factors influence prognosis in MUS?

Answer 35

Less complex and recent onset cases have a good prognosis while chronic

Question 36

How does culture affect somatization and MUS?

Answer 36

Culture shapes the expression of somatic and psychosocial distress determines which symptoms are considered normal or abnormal

Question 37

Why is somatization described as an “idiom of distress” in some cultures?

Answer 37

Because in cultures where psychiatric stigma exists and emotional distress expression is inhibited somatization serves as an alternative way to communicate distress.

Question 38

How do patients from non-Western cultures typically express emotional distress?

Answer 38

They are often less willing or less able to express emotional distress verbally may lack vocabulary to label emotions