Medically unexplained symptoms in frequent attenders of secondary health care: retrospective cohort study
Medically unexplained symptoms in frequent attenders of secondary health care: retrospective cohort study
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DOI：
10.1136/bmj.322.7289.767
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发表时间：
2001-03-31
影响因子：
--
通讯作者：
Hotopf, M
中科院分区：
文献类型：
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作者：
Reid, S;Wessely, S;Hotopf, M
目的评估门诊就诊患者中不明原因症状的患病率。采用回顾性队列研究方法，对3年多的病例记录进行回顾，在泰晤士河南岸(西)NHS地区设置二级保健服务，1993年新就诊患者。主要指标门诊就诊次数和就诊次数。结果共抽查400名就诊者中的361人，记录就诊次数971次。97例(27%)有一次或多次会诊，病情在医学上无法解释；在971次会诊中，有208例(21%)在医学上无法解释。腹痛、胸痛、头痛和背痛通常被发现是医学上无法解释的。结论医学上无法解释的症状存在于大多数医院的专科中，并在二级护理中经常就诊的患者中占相当大的比例。
Objective To estimate the prevalence of medically unexplained symptoms in patients who most frequently attend outpatient services.Design Retrospective cohort study over three years with review of case notes.Setting Secondary care services in the South Thames (West) NHS region,Participants Outpatient attenders with new appointments in 1993.Main outcome measures Number of outpatient appointments, and number of consultation episodes for medically unexplained conditions.Results Medical records of 361 of 400 sampled frequent attenders were examined, and 971 consultation episodes were recorded. Ninety seven (27%) had one or more consultation episodes in which the condition was medically unexplained; 208 (21%) of the 971 consultation episodes were medically unexplained. Abdominal pain, chest pain, headache, and back pain were commonly found to be medically unexplained.Conclusions Medically unexplained symptoms present in most hospital specialties and account for a considerable proportion of consultations by frequent attenders in secondary care.