Medically unexplained physical symptoms in elderly people: a pilot study of psychiatric geriatric characteristics.
OBJECTIVE
To examine the somatic complaints, functional impairment, and psychiatric comorbidity in elderly patients with medically unexplained symptoms (MUSs).


METHODS
A consecutive case series of 37 patients referred for MUS to a multidisciplinary, outpatient clinic at a secondary care mental health center in the Netherlands. All patients underwent a standardized examination by a geriatrician, psychiatrist, and psychologist.


RESULTS
For three patients, a somatic explanation was found, and in two, their symptoms spontaneously resolved before a diagnosis could be made. Of the remaining 32 patients with MUS, depressive disorders were present in 18 (56%), anxiety disorders in 10 (31%), and substance use disorders in 6 patients (19%). Compared with nondepressed patients with MUS, depressed patients had more severe somatic symptoms, more psychological symptoms, and more functional impairment.


CONCLUSIONS
As the authors found a high comorbidity with other psychiatric disorders in elderly patients with MUSs, a systematic psychiatric examination should be part of their multidisciplinary assessment.
Hilderink
Peter H
PH
GGZ Nijmegen, Department of Old-Age Psychiatry, Radboud Univeristy Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, The Netherlands. philderink@ggznijmegen.nl
Benraad
Caroline E M
CE
van Driel
Dorine
D
Buitelaar
Jan K
JK
Speckens
Anne E M
AE
Olde Rikkert
Marcel G M
MG
Voshaar
Richard C Oude
RC
D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004562:Electrocardiography; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires