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Quality of life in primary care patients with moderate medically unexplained physical symptoms

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Abstract

Purpose

Medically Unexplained Physical Symptoms (MUPS) have a large impact on patient’s quality of life. Most studies have been limited to chronic MUPS and thus, little is known about moderate MUPS. Improved knowledge concerning determinants influencing quality of life in moderate MUPS patients can be helpful in managing MUPS. This study is aimed at describing the common characteristics seen in moderate MUPS patients and compare them with characteristics seen in chronic MUPS patients and general population. We also identified determinants of the physical and mental components of quality of life in moderate MUPS patients.

Methods

In a cross-sectional study, moderate MUPS patients (n = 160) were compared with chronic MUPS patients (n = 162) and general population (n = 1742) based on demographic characteristics and patient’s quality of life. Multivariable linear regression analyses were performed to identify determinants associated with a patient’s quality of life, assessed with the RAND-36.

Results

Moderate MUPS patients experienced a better quality of life than chronic MUPS patients, but a worse quality of life as compared to the general population. Determinants associated with the physical and mental components of quality of life explain 49.1% and 62.9% of the variance, respectively.

Conclusion

Quality of life of patients with MUPS varies with MUPS disease stage. Based on their quality of life scores, moderate MUPS patients would be adequately distinguished from chronic MUPS patients. Half of the variance in the physical component and almost two thirds of the mental component would be explained by a number of MUPS-related symptoms and perceptions.

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Abbreviations

Brief IPQ:

Brief Illness Perception Questionnaire

DSM:

Diagnostic and Statistical Manual of Mental Disorders

GP:

General Practitioner

MCS:

Mental Component Scale

MUPS:

Medically Unexplained Physical Symptoms

MVPA:

Moderate or Vigorous Physical Activity

NRS:

Numeric Rating Scale

PCS:

Physical Component Scale

PRESUME:

Preventive screening of medically unexplained physical symptoms

RAND-36:

36-Item Short Form Health Survey

VIF:

Variance of inflation factor

4DSQ:

Four-Dimensional Symptom Questionnaire

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Acknowledgements

The authors would like to thank the authors of the articles from which the data of the patients with chronic MUPS and the general population was obtained.

Funding

This work was supported by SIA-RAAK-public [Grant No. 2015-02-24P].

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Authors and Affiliations

  1. Department of Health Innovation and Technology, Fontys University of Applied Sciences, Ds Th Fliednerstraat 2, 5600 AH, Eindhoven, The Netherlands

    P. E. van Westrienen, M. F. Pisters & S. A. J. Toonders

  2. Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, The Netherlands

    P. E. van Westrienen, M. F. Pisters, S. A. J. Toonders & C. Veenhof

  3. Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands

    P. E. van Westrienen, M. F. Pisters, S. A. J. Toonders & C. Veenhof

  4. Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    M. Gerrits & N. J. de Wit

  5. Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands

    C. Veenhof

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  1. P. E. van Westrienen
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Correspondence to P. E. van Westrienen.

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van Westrienen, P.E., Pisters, M.F., Toonders, S.A.J. et al. Quality of life in primary care patients with moderate medically unexplained physical symptoms. Qual Life Res 29, 693–703 (2020). https://doi.org/10.1007/s11136-019-02358-8

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