A qualitative analysis of explanatory models in medically unexplained physical symptoms presenting to a tertiary health care psychiatric facility in South India

Vikas Menon, Balasubramanian Shanmuganathan, Anand Babu Arun, Jaiganesh Selvapandian Thamizh, Nivedhitha Selvakumar and Siddharth Sarkar

International Journal of Social Psychiatry, 2016, vol. 62, issue 7, 608-615

Abstract: Background: Knowledge about subjective perceptions and explanatory models has the potential to inform clinical evaluation and lead to development of patient-friendly treatment models in medically unexplained physical symptoms (MUPS). Aim: To collect qualitative data about explanatory models in MUPS. Methods: A cross-sectional observational study was done among patients with MUPS presenting over a 2-year period to a specialty psychosomatic clinic. The Short Explanatory Model of Illness interview was used to gather qualitative data about explanatory models which were subsequently recoded using standard manuals. Results: A total of 123 subjects were evaluated. The nature of symptoms was most commonly reported as ‘non-specific’ ( n  = 102, 82.9%) but of moderate to severe intensity ( n  = 87, 73.8%). Getting cured or showing improvement was the most common expectation from treatment ( n  = 58, 47.9%). Moderate to severe impact of symptoms was reported on work output ( n  = 100, 84%), emotional life ( n  = 85, 71.4%) and physical mobility ( n  = 59, 49.1%). A considerable proportion was either dissatisfied ( n  = 61, 50%) or frankly unhappy ( n  = 38, 31.4%) with treatment received. Conclusion: There is a need to re-calibrate the clinical approach to people with MUPS to enhance treatment satisfaction. Our findings could assist in evolving culturally sensitive conceptualizations of illness and in developing patient-centred models for therapy in MUPS patients.

Keywords: Medically unexplained symptoms; explanatory models; qualitative research; somatoform disorder; somatization; physical symptoms (search for similar items in EconPapers)
Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:62:y:2016:i:7:p:608-615

DOI: 10.1177/0020764016662294

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