title: Medically unexplained otorhinolaryngological symptoms: Towards integrated psychiatric care.
abstract: OBJECTIVE
  To evaluate the presence of medically unexplained otorhinolaryngological symptoms in a patient cohort and propose an interdisciplinary approach for their care.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  The study describes the population of patients presenting consecutively at the Department of Otorhinolaryngology at the Maastricht University Medical Center. Patients with symptoms who did not meet clear "medical" criteria and were associated with psychological distress and high health care utilization were enrolled in the study by two experienced otorhinolaryngologists following informed consent. The aim of the study is 1) to specify the presence of medically unexplained otorhinolaryngological symptoms and 2) to evaluate the integration of otorhinolaryngological and psychiatric treatment in an interdisciplinary approach in order to help otorhinolaryngologists improve patient care.
  
  
  RESULTS
  Of the 102 patients included, 41% (N = 42) did not have a proven somatic otorhinolaryngological diagnosis. For only 10.8% (N = 4) of the latter, no psychiatric diagnosis had been established. Overall, 78% of the study population (N = 80) was diagnosed with psychiatric morbidity/comorbidity, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
  
  
  CONCLUSIONS
  The preliminary data suggest that the majority of patients with these unexplained complaints may suffer from under- or undiagnosed psychiatric morbidity. Therefore, easy access to integrated interdisciplinary care (otorhinolaryngology and psychiatry) should be offered to patients with medically unexplained otorhinolaryngological symptoms after detailed information is made available to them about the pathogenesis of the complaints and the foreseen psychosomatic approach.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht, The Netherlands.
authors.forename: Laura W J
authors.initials: LW
authors.lastname: Baijens
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht, The Netherlands.|Emergency Department, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Verdonschot
authors.affiliation: Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands.
authors.forename: Sophie
authors.initials: S
authors.lastname: Vanbelle
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht, The Netherlands.|Department of Anesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Sonja
authors.initials: S
authors.lastname: Basic
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht, The Netherlands.
authors.forename: Bernd
authors.initials: B
authors.lastname: Kremer
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht, The Netherlands.
authors.forename: Raymond
authors.initials: R
authors.lastname: van de Berg
authors.affiliation: Departments of Psychiatry and Medical Psychology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Carsten
authors.initials: C
authors.lastname: Leue
mesh_terms: D000368:Aged; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010038:Otorhinolaryngologic Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies
keywords: Psychiatric comorbidity; unexplained otorhinolaryngological symptoms