title: Patient-doctor interaction, psychobehavioural characteristics and mental disorders in patients with suspected allergies: do they predict "medically unexplained symptoms"?
abstract: In approximately 20% of patients with suspected allergies, no organic symptom explanation can be found. Limited knowledge about patients with "medically unexplained symptoms (MUS)" contributes to them being perceived as "difficult" and being treated inadequately. This study examined the psychobehavioural characteristics of patients presenting for a diagnostic allergy work-up. Patients were interviewed and completed various self-rating questionnaires. Patient-Doctor interaction was evaluated, and the organic explicability of the patients' symptoms was rated by allergists. Patients with vs. those without MUS differed in several respects. Mental comorbidity, female sex, dissatisfaction with care, and a problematic countertransference (the interviewer's feelings towards the patient) independently predicted MUS. Patients whose symptoms could be explained organically reported more psychobehavioural problems than a control group of immuno-therapy patients. There were no differences in patient-doctor interaction. In patients with suspected allergies, recognition of psychological burden and concurrent mental disorders is important. Mental comorbidity and a difficult patient-doctor interaction may predict MUS.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Technische Universitaet Muenchen, Munich, Germany. c.hausteiner-wiehle@tum.de
authors.forename: Constanze
authors.initials: C
authors.lastname: Hausteiner-Wiehle
authors.forename: Martine
authors.initials: M
authors.lastname: Grosber
authors.forename: Esther
authors.initials: E
authors.lastname: Bubel
authors.forename: Sylvienne
authors.initials: S
authors.lastname: Groben
authors.forename: Susanne
authors.initials: S
authors.lastname: Bornschein
authors.forename: Claas
authors.initials: C
authors.lastname: Lahmann
authors.forename: Florian
authors.initials: F
authors.lastname: Eyer
authors.forename: Bernadette
authors.initials: B
authors.lastname: Eberlein
authors.forename: Heidrun
authors.initials: H
authors.lastname: Behrendt
authors.forename: Bernd
authors.initials: B
authors.lastname: Löwe
authors.forename: Peter
authors.initials: P
authors.lastname: Henningsen
authors.forename: Dorothea
authors.initials: D
authors.lastname: Huber
authors.forename: Johannes
authors.initials: J
authors.lastname: Ring
authors.forename: Ulf
authors.initials: U
authors.lastname: Darsow
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D003379:Countertransference; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012737:Sex Factors; D013001:Somatoform Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires