Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics
Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics
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DOI：
10.1136/jnnp.68.2.207
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发表时间：
2000-02-01
影响因子：
11
通讯作者：
Sharpe, M
中科院分区：
文献类型：
--
作者：
Carson, AJ;Ringbauer, B;Sharpe, M
目的-确定（a）转诊到普通神经科门诊的患者中，其症状无法解释的比例;（B）他们转诊的原因;（c）将这一组患者的健康状况和情绪障碍与症状由“器质性”神经系统疾病解释的患者进行比较。在苏格兰洛锡安的区域神经病学服务中心进行了前瞻性队列研究，其中有300名新转诊的门诊患者，随访6个月。神经科医生对病人的症状在何种程度上可以用器质性疾病来解释进行评级（器质性）、全科医生转诊原因、健康状况（SF-36）、焦虑和抑郁障碍（PRIME-MD），结果-300例新患者中11%（95%置信区间（95% CI）7%-14%）有症状被评为“根本无法解释”的器质性疾病，19%（15%至23%）“部分解释”，27%（22%至32%）“主要解释”，43%（37%至49%）“完全解释”器质性疾病。转诊原因与“有机性”无关。这些组的比较表明，虽然身体功能相似，但器官评分较低的患者的身体症状和疼痛的中位数更大（p
Objectives-To determine (a) the proportion of patients referred to general neurology outpatient clinics whose symptoms are medically unexplained; (b) why they were referred; (c) health status and emotional disorder in this group compared with patients whose symptoms are explained by "organic" neurological disease.Methods-The prospective cohort study with case note follow up at 6 months was carried out in the regional neurology service in Lothian, Scotland with 300 newly referred outpatients. Neurologists rated the degree to which patients' symptoms were explained by organic disease (organicity), GPs' reasons for referral, health status (SF-36), anxiety, and depressive disorders (PRIME-MD),Results-Of 300 new patients 11% (95% confidence interval (95% CI) 7%-14%) had symptoms that were rated as "not at all explained" by organic disease, 19% (15% to 23%) "somewhat explained", 27% (22% to 32%) "largely explained", and 43% (37% to 49%) "completely explained" by organic disease. Reason for referral was not associated with "organicity". Comparison of these groups showed that although physical function was similar, the median number of physical symptoms and pain were greater in patients with lower organicity ratings (p