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

  • P. E. van WestrienenEmail author
  • M. F. Pisters
  • S. A. J. Toonders
  • M. Gerrits
  • N. J. de Wit
  • C. Veenhof
Article

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.

Keywords

Medically Unexplained Physical Symptoms Primary care Quality of life SF-36 

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

Notes

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].

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Health Innovation and TechnologyFontys University of Applied SciencesEindhovenThe Netherlands
  2. 2.Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care CentersUtrechtThe Netherlands
  3. 3.Physical Therapy Research, Department of RehabilitationPhysical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center UtrechtUtrechtThe Netherlands
  4. 4.Department of General Practice, Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
  5. 5.Research Group Innovation of Human Movement CareUniversity of Applied Sciences UtrechtUtrechtThe Netherlands

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