title: Psychosocioeconomic study of medically unexplained physical symptoms.
abstract: BACKGROUND
  There is a paucity of studies done on medically unexplained physical symptoms (MUPS) in Kerala, India. The objective of this study was to examine the sociodemographic and other clinical variables associated with this condition.
  
  
  METHODS
  The clinical sample was taken from the General Medicine Clinic of a tertiary care hospital, in Kerala. The referred cases meeting the criteria (N=48) for medically unexplained physical symptoms were enrolled for this cross-sectional study. The medical doctor with experience in psychiatry completed the questionnaire.
  
  
  RESULTS
  Most of the patients were middle-aged females from rural areas. The most common symptom reported was headache. Most of the patients had symptoms for five years or more and had seen two-to-five consultants. A majority of the patients had undergone special investigations and a few had expensive and invasive investigations. Cluster C personality disorders were the most common associated personality disorders with medically unexplained physical symptoms.
  
  
  CONCLUSIONS
  To our knowledge this is the first psychosocioeconomic study on medically unexplained physical symptoms, done in Kerala, India. Medically unexplained physical symptoms cause loss of productivity and economic burden and are a major public health problem. Future studies are warranted focusing on non-pharmacological treatment, psycho-education on mind-body association, and medical models on specific cytokines associated with medically unexplained physical symptoms for personalized management, and to examine the effect of a combination of pharmacotherapy and cognitive behavioral therapy.
authors.affiliation: Department of Psychiatry, Postdoctoral Fellow, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA.
authors.forename: Maju Mathew
authors.initials: MM
authors.lastname: Koola
authors.forename: Praveenlal
authors.initials: P
authors.lastname: Kuttichira