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

Author

Listed:
  • Vikas Menon
  • Balasubramanian Shanmuganathan
  • Anand Babu Arun
  • Jaiganesh Selvapandian Thamizh
  • Nivedhitha Selvakumar
  • Siddharth Sarkar

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.

Suggested Citation

  • Vikas Menon & Balasubramanian Shanmuganathan & Anand Babu Arun & Jaiganesh Selvapandian Thamizh & Nivedhitha Selvakumar & Siddharth Sarkar, 2016. "A qualitative analysis of explanatory models in medically unexplained physical symptoms presenting to a tertiary health care psychiatric facility in South India," International Journal of Social Psychiatry, , vol. 62(7), pages 608-615, November.
    • Handle: RePEc:sae:socpsy:v:62:y:2016:i:7:p:608-615
    DOI: 10.1177/0020764016662294
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    References listed on IDEAS

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    1. Peters, Sarah & Stanley, Ian & Rose, Michael & Salmon, Peter, 0. "Patients with medically unexplained symptoms: Sources of patients' authority and implications for demands on medical care," Social Science & Medicine, Elsevier, vol. 46(4-5), pages 559-565, February.
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