Skip to main content
Top
Published in: BioPsychoSocial Medicine 1/2017

Open Access 01-12-2017 | Research

Clinical features of outpatients with somatization symptoms treated at a Japanese psychosomatic medicine clinic

Authors: Yuzo Nakamura, Takeaki Takeuchi, Kazuaki Hashimoto, Masahiro Hashizume

Published in: BioPsychoSocial Medicine | Issue 1/2017

Login to get access

Abstract

Background

Somatization is produced due to the summation of psychological factors, irrespective of the presence or absence of physical factors. A group of diseases with severe pain and other disorders exhibit so-called Medically Unexplained Symptoms (MUS), and the characteristics of patients with MUS are largely unexplained. In this paper, the characteristics of a series of new patients with somatization treated in a Japanese university hospital are discussed.

Method

The subjects were 871 patients who newly visited the Department of Psychosomatic Medicine, Toho University Omori Medical Center between January and December of 2015. Under the assumption that the definition of somatization is same as that of MUS, the correlation between somatization and the age, sex, academic background, chief complaints, reasons for visiting the medical center, diagnosis, symptoms, presence or absence of a referral form, continued treatment after the first visit, and marital status of these patients at the time of their respective examinations were evaluated.

Results

Of the patients studied, 68% suffered from somatization. Among them, 11% met the definition of Functional Somatic Symptoms (FSS) and 74% had somatization associated with mood disorder or anxiety disorder. Digestive symptoms were reported by 33%, headaches by 24%, and unusual sensations by 21%. Whereas no correlation was found between somatization symptoms and the patients’ academic background, marital history, or medical history after the first visit, a positive correlation (p < 0.05) was found between somatization and patients who had been referred by their doctor.

Conclusion

Many of the studied patients who suffered from somatization, regardless of age and sex, were referred to us by doctors from other hospitals. It was concluded that many patients difficult to diagnose or deal with are referred the Department of Psychosomatic Medicine of Japanese university hospitals, thus these hospitals must assume great responsibility for preventing mistaken diagnoses by conducting effective psychological treatment and thorough medical examinations.
Literature
1.
go back to reference Lipowski ZJ. Somatization: the concept and its clinical application. Am J Psychiatry. 1988;145:1358–68.CrossRefPubMed Lipowski ZJ. Somatization: the concept and its clinical application. Am J Psychiatry. 1988;145:1358–68.CrossRefPubMed
2.
go back to reference Barsky AJ, Borus JF. Functional somatic syndromes. Ann Interrn Med. 1999;130:910–21.CrossRef Barsky AJ, Borus JF. Functional somatic syndromes. Ann Interrn Med. 1999;130:910–21.CrossRef
3.
go back to reference Kroenke K, Rosmalen JG. Symptoms syndromes, and the value of psychiatric diagnostics in patients who have functional somatic disorders. Med Clin North Am. 2006;90:603–26.CrossRefPubMed Kroenke K, Rosmalen JG. Symptoms syndromes, and the value of psychiatric diagnostics in patients who have functional somatic disorders. Med Clin North Am. 2006;90:603–26.CrossRefPubMed
4.
go back to reference Hamilton J, Campos R, et.al. Anxiety, depression and management of medically unexplained symptoms in medical clinics. J the Royal College of Physicians London 1996;30:18-20. Hamilton J, Campos R, et.al. Anxiety, depression and management of medically unexplained symptoms in medical clinics. J the Royal College of Physicians London 1996;30:18-20.
5.
go back to reference Rask MT, Rosendal M, et.al. Sick leave and work disability in primary care patients with recent-onset multiple medically unexplained symptoms and persistent somatoform disorders: a 10-year follow-up of the FIP study. Gen Hosp Psychiatry 2015;37:53-59. Rask MT, Rosendal M, et.al. Sick leave and work disability in primary care patients with recent-onset multiple medically unexplained symptoms and persistent somatoform disorders: a 10-year follow-up of the FIP study. Gen Hosp Psychiatry 2015;37:53-59.
6.
go back to reference Rynolds KJ, Vernon SD, et al. The economic impact of chronic fatigue syndrome. Cost Effectiveness and Resource Allocation. 2008;2:4.CrossRef Rynolds KJ, Vernon SD, et al. The economic impact of chronic fatigue syndrome. Cost Effectiveness and Resource Allocation. 2008;2:4.CrossRef
8.
go back to reference Francis C, Peer H, et al. Medically unexplained symptoms, somatization and bodily distress. CAMBRIDGE UNIVERSITY PRESS. 2011; Francis C, Peer H, et al. Medically unexplained symptoms, somatization and bodily distress. CAMBRIDGE UNIVERSITY PRESS. 2011;
9.
go back to reference Nakao M. Etiology of functional somatic syndromes. Nippon Rinsho. 2009;67:1661–7.PubMed Nakao M. Etiology of functional somatic syndromes. Nippon Rinsho. 2009;67:1661–7.PubMed
10.
go back to reference Nimnuan C, Hotopf M, et al. Medically unexplained symptoms: how often and why are they missed? QJM. 2000;93:21–8.CrossRefPubMed Nimnuan C, Hotopf M, et al. Medically unexplained symptoms: how often and why are they missed? QJM. 2000;93:21–8.CrossRefPubMed
11.
go back to reference van Eck van der Sluijs JF, Ten Have M, et.al. Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study. Neuropsychiatr Dis Treat 2016;16:2063-2072. van Eck van der Sluijs JF, Ten Have M, et.al. Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study. Neuropsychiatr Dis Treat 2016;16:2063-2072.
12.
go back to reference Hiroyuki S. Historical transition of psychosomatic medicine (psychosomatic medicine) in clinical medicine. Medicina. 1995;32:1058–61. Hiroyuki S. Historical transition of psychosomatic medicine (psychosomatic medicine) in clinical medicine. Medicina. 1995;32:1058–61.
13.
go back to reference Koji T. Think about next-generation psychosomatic medicine. Japan J Psychosoma int. 2015;19:147–50. Koji T. Think about next-generation psychosomatic medicine. Japan J Psychosoma int. 2015;19:147–50.
14.
go back to reference Noriyuki T. Medical education/postgraduate education what I would like to do for psychosomatic medicine education before graduation from the viewpoint of general examination department. Japan J Psychosoma int. 2014;18:196–203. Noriyuki T. Medical education/postgraduate education what I would like to do for psychosomatic medicine education before graduation from the viewpoint of general examination department. Japan J Psychosoma int. 2014;18:196–203.
15.
go back to reference Kenji K, Hiroki M. Indefinite complaint clinical practice! On indefinite complaints often seen in internal medicine. Modern Physician. 2015;35:936–8. Kenji K, Hiroki M. Indefinite complaint clinical practice! On indefinite complaints often seen in internal medicine. Modern Physician. 2015;35:936–8.
16.
go back to reference Hiller W, Rief W, et.al. Somatization in the population: from mild bodily misperceptions to disabling symptoms. Soc Psychiatry Psychiatr Epidemiol 2006;41:704-712. Hiller W, Rief W, et.al. Somatization in the population: from mild bodily misperceptions to disabling symptoms. Soc Psychiatry Psychiatr Epidemiol 2006;41:704-712.
17.
go back to reference Deary V, Chalder T et.al. The cognitive behavioral model of medically unexplained symptoms: a theoretical and empirical review. Clinical psycho review 2007;27:781-797. Deary V, Chalder T et.al. The cognitive behavioral model of medically unexplained symptoms: a theoretical and empirical review. Clinical psycho review 2007;27:781-797.
18.
go back to reference Nakao M, Takeuchi T. Clinical characteristics and referral patterns of outpatients visiting a Japanese psychosomatic medicine clinic. International Journal of Behavioral Medicine. 2015;20:1–9. Nakao M, Takeuchi T. Clinical characteristics and referral patterns of outpatients visiting a Japanese psychosomatic medicine clinic. International Journal of Behavioral Medicine. 2015;20:1–9.
19.
go back to reference Nakao M, Takeuchi T, Fricchione G. Definition of psychosomatic medicine and the applicability of DSM-IV-TR. Psychotherapy and Psyshosomatics. 2014;83:120–1.CrossRef Nakao M, Takeuchi T, Fricchione G. Definition of psychosomatic medicine and the applicability of DSM-IV-TR. Psychotherapy and Psyshosomatics. 2014;83:120–1.CrossRef
20.
go back to reference Karin H, Mariko M, et al. Electroencephalogram abnormalities in panic disorder patients: a study of symptom characteristics and pathology. Biopsychosocial Med. 2010;23:1–9. Karin H, Mariko M, et al. Electroencephalogram abnormalities in panic disorder patients: a study of symptom characteristics and pathology. Biopsychosocial Med. 2010;23:1–9.
21.
go back to reference Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol. 2000;95:3503–6.CrossRefPubMed Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol. 2000;95:3503–6.CrossRefPubMed
22.
go back to reference Slattery SA, Niaz O, et al. Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhea. Aliment Pharmacol Ther. 2015;42:3–11.CrossRefPubMed Slattery SA, Niaz O, et al. Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhea. Aliment Pharmacol Ther. 2015;42:3–11.CrossRefPubMed
23.
go back to reference Hirohisa O, Yasuhisa K. Overlookable chronic hypertrophic pachymeningitis. Mebio. 2008;25:60–5. Hirohisa O, Yasuhisa K. Overlookable chronic hypertrophic pachymeningitis. Mebio. 2008;25:60–5.
24.
go back to reference Sirri L, Grandi S, et.al. Medically unexplained symptoms and general practitioners: a comprehensive survey about their attitudes, experiences and management strategies. Fam Pract. 2017 34(2):. doi: 10.1093/fampra/cmw130. [Epub ahead of print]. Sirri L, Grandi S, et.al. Medically unexplained symptoms and general practitioners: a comprehensive survey about their attitudes, experiences and management strategies. Fam Pract. 2017 34(2):. doi: 10.​1093/​fampra/​cmw130. [Epub ahead of print].
25.
go back to reference Maatz A, Wainwright M, et al. What's 'difficult'? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms. J Psychosom Res. 2016 Nov;90:1–9.CrossRefPubMed Maatz A, Wainwright M, et al. What's 'difficult'? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms. J Psychosom Res. 2016 Nov;90:1–9.CrossRefPubMed
26.
go back to reference Burton C. Beyond somatization: a review of the understanding and treatment of medically unexplained physical symptoms(MUPS). Br J Gen Pract. 2003;53:231–9.PubMedPubMedCentral Burton C. Beyond somatization: a review of the understanding and treatment of medically unexplained physical symptoms(MUPS). Br J Gen Pract. 2003;53:231–9.PubMedPubMedCentral
27.
go back to reference Hanssen DJ, Oude Voshaar RC. Et.Al social characteristics and care needs of older persons with medically unexplained symptoms: a case-control study. Fam Pract. 2016;33(6):617–25.CrossRefPubMed Hanssen DJ, Oude Voshaar RC. Et.Al social characteristics and care needs of older persons with medically unexplained symptoms: a case-control study. Fam Pract. 2016;33(6):617–25.CrossRefPubMed
Metadata
Title
Clinical features of outpatients with somatization symptoms treated at a Japanese psychosomatic medicine clinic
Authors
Yuzo Nakamura
Takeaki Takeuchi
Kazuaki Hashimoto
Masahiro Hashizume
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BioPsychoSocial Medicine / Issue 1/2017
Electronic ISSN: 1751-0759
DOI
https://doi.org/10.1186/s13030-017-0104-x

Other articles of this Issue 1/2017

BioPsychoSocial Medicine 1/2017 Go to the issue