Un tercio de los síntomas comunes no tienen explicación evidente | 01 DIC 14

Síntomas comunes: un enfoque práctico basado en la evidencia

Más de la mitad de las consultas al médico son por síntomas físicos. En estos casos, además de tratamientos farmacológicos y conductuales, la comunicación médico-paciente tiene valor terapéutico.
Autor/a: Kroenke K, MD Fuente: Ann Intern Med. 2014;161:579-586. A Practical and Evidence-Based Approach to Common Symptoms. A Narrative Review
INDICE:  1.  | 2. Referencias
Referencias

1. Kroenke K. Studying symptoms: sampling and measurement issues. Ann Intern Med. 2001; 134:844-53. [PMID: 11346320]
2. Green LA, Fryer GE Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001; 344:2021-5. [PMID: 11430334]
3. Kroenke K, Spitzer RL, Williams JB, Linzer M, Hahn SR, deGruy FV 3rd, et al. Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment. Arch Fam Med. 1994; 3:774-9. [PMID: 7987511]
4. Kroenke K. Patients presenting with somatic complaints: epidemiology, psychiatric comorbidity and management. Int J Methods Psychiatr Res. 2003; 12:34-43. [PMID: 12830308]
5. Hahn SR. Physical symptoms and physician-experienced difficulty in the physician-patient relationship. Ann Intern Med. 2001; 134:897-904. [PMID: 11346326]
6. Kroenke K, Mangelsdorff AD. Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome. Am J Med. 1989; 86:262-6. [PMID:
2919607]
7. Khan AA, Khan A, Harezlak J, Tu W, Kroenke K. Somatic symptoms in primary care: etiology and outcome. Psychosomatics. 2003; 44:471-8.
8. Marple RL, Kroenke K, Lucey CR, Wilder J, Lucas CA. Concerns and expectations in patients presenting with physical complaints. Frequency, physician perceptions and actions, and 2-week outcome. Arch Intern Med. 1997; 157: 1482-8.
9. Steinbrecher N, Koerber S, Frieser D, Hiller W. The prevalence of medically unexplained symptoms in primary care. Psychosomatics. 2011; 52:263-71.
10. Reid S, Wessely S, Crayford T, Hotopf M. Medically unexplained symptoms in frequent attenders of secondary health care: retrospective cohort study. BMJ. 2001; 322:767. [PMID: 11282861]
11. Kroenke K, Price RK. Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med. 1993; 153:2474-80. [PMID: 8215752]
12. Escobar JI, Cook B, Chen CN, Gara MA, Alegría M, Interian A, et al. Whether medically unexplained or not, three or more concurrent somatic symptoms predict psychopathology and service use in community populations. J Psychosom Res. 2010; 69:1-8. [PMID: 20630257] doi:10.1016/j.jpsychores .2010.01.001
13. National Research Council. Gulf War and Health: Treatment for Chronic Multisymptom Illness. Washington, DC: National Academies Pr; 2013.
14. Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. J Pain. 2011; 12:964-73. [PMID: 21680251] doi:10.1016/JJ pain .2011.03.003
15. Löwe B, Spitzer RL, Williams JB, Mussell M, Schellberg D, Kroenke K. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. Gen Hosp Psychiatry. 2008; 30:191-9.
16. Kroenke K. Somatoform disorders and recent diagnostic controversies. Psychiatr Clin North Am. 2007; 30:593-619. [PMID: 17938036]
17. 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. [PMID: 16843765]
18. Katon W, Lin EH, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. Gen Hosp Psychiatry. 2007; 29:147-55. [PMID: 17336664]
19. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE Jr, Wehrle PA, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992; 117:898-904. [PMID: 1443950]
20. Schmitt BP, Kushner MS, Wiener SL. The diagnostic usefulness of the history of the patient with dyspnea. J Gen Intern Med. 1986; 1:386-93.
21. Kroenke K, Jackson JL, Chamberlin J. Depressive and anxiety disorders in patients presenting with physical complaints: clinical predictors and outcome. Am J Med. 1997; 103:339-47. [PMID: 9375700]
22. Barsevick AM. The concept of symptom cluster. Semin Oncol Nurs. 2007;23:89-98. [PMID: 17512435]
23. Aktas A, Walsh D, Rybicki L. Symptom clusters: myth or reality? Palliat Med. 2010; 24:373-85. [PMID: 20507866] doi: 10.1177/0269216310367842
24. Hanel G, Henningsen P, Herzog W, Sauer N, Schaefert R, Szecsenyi J, et al. Depression, anxiety, and somatoform disorders: vague or distinct categories in primary care? Results from a large cross-sectional study. J Psychosom Res 2009; 67:189-97. 25. Gardner JW, Gibbons RV, Hooper TI, Cunnion SO, Kroenke K, Gackstetter GD. Identifying new diseases and their causes: the dilemma of illnesses in Gulf War veterans. Mil Med. 2003; 168:186-93. [PMID: 12685682]
26. Aaron LA, Buchwald D. A review of the evidence for overlap among unexplained clinical conditions. Ann Intern Med. 2001; 134:868-81. [PMID: 11346323]
27. Hampton JR, Harrison MJ, Mitchell JR, Prichard JS, Seymour C. Relative contributions of history-taking, physical examination, and laboratory investigation to diagnosis and management of medical outpatients. Br Med J. 1975; 2: 486-9. [PMID: 1148666]
28. Sandler G. The importance of the history in the medical clinic and the cost of unnecessary tests. Am Heart J. 1980; 100:928-31. [PMID: 7446394]
29. Gruppen LD, Woolliscroft JO, Wolf FM. The contribution of different components of the clinical encounter in generating and eliminating diagnostic hypotheses. Res Med Educ. 1988; 27:242-7. [PMID: 3218864]
30. Peterson MC, Holbrook JH, Von Hales D, Smith NL, Staker LV. Contributions of the history, physical examination, and laboratory investigation in making medical diagnoses. West J Med. 1992; 156:163-5. [PMID: 1536065]
31. Martina B, Bucheli B, Stotz M, Battegay E, Gyr N. First clinical judgment by primary care physicians distinguishes well between nonorganic and organic causes of abdominal or chest pain. J Gen Intern Med. 1997; 12:459-65. [PMID: 9276650]
32. Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA. 1992; 268:760-5. [PMID: 1386391]
33. Pryor DB, Shaw L, McCants CB, Lee KL, Mark DB, Harrell FE Jr, et al. Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Intern Med. 1993; 118:81-90. [PMID: 8416322]
34. Rich EC, Crowson TW, Harris IB. The diagnostic value of the medical history. Perceptions of internal medicine physicians. Arch Intern Med. 1987; 147:1957-60. 35.
35. Joung MJ, Poses RM. Medical student perceptions of the value of the history and physical examination. J Med Educ. 1983; 58:738-9. [PMID: 6887220]
36. Hoffman RM, Einstadter D, Kroenke K. Evaluating dizziness. Am J Med 1999; 107:468-78. [PMID: 10569302]
37. Rolfe A, Burton C. Reassurance after diagnostic testing with a low pretest probability of serious disease: systematic review and meta-analysis. JAMA Intern Med. 2013; 173:407-16. [PMID: 23440131] doi:10.1001/jamainternmed .2013.2762
38. Kroenke K. Diagnostic testing and the illusory reassurance of normal results: comment on “Reassurance after diagnostic testing with a low pretest probability of serious disease”. JAMA Intern Med. 2013; 173:416-7.
39. Wasson JH, Sox HC Jr, Sox CH. The diagnosis of abdominal pain in ambulatory male patients. Med Decis Making. 1981; 1:215-24. [PMID: 7052409]
40. Von Korff M, Deyo RA, Cherkin D, Barlow W. Back pain in primary care. Outcomes at 1 year. Spine (Phila Pa 1976). 1993; 18:855-62. [PMID: 8316884]
41. Costa Lda C, Maher CG, McAuley JH, Hancock MJ, Herbert RD, Refshauge KM, et al. Prognosis for patients with chronic low back pain: inception cohort study. BMJ. 2009; 339:b3829. [PMID: 19808766] doi:10.1136/bmj.b3829
42. Sox HC Jr, Margulies I, Sox CH. Psychologically mediated effects of diagnostic tests. Ann Intern Med. 1981; 95:680-5. [PMID: 7305144]
43. Hawkins CF, Cockel R. The prognosis and risk of missing malignant disease in patients with unexplained and functional diarrhoea. Gut. 1971; 12:208-11.
44. Kroenke K, Wood DR, Mangelsdorff AD, Meier NJ, Powell JB. Chronic fatigue in primary care. Prevalence, patient characteristics, and outcome. JAMA 1988; 260:929-34. [PMID: 3398197]
45. Kroenke K, Lucas C, Rosenberg ML, Scherokman B, Herbers JE. One-year outcome for patients with a chief complaint of dizziness. J Gen Intern Med. 1994; 9:684-9. [PMID: 7876951]
46. Weber BE, Kapoor WN. Evaluation and outcomes of patients with palpitations. Am J Med. 1996; 100:138-48. [PMID: 8629647]
47. Stone J, Carson A, Duncan R, Coleman R, Roberts R, Warlow C, et al. Symptoms ‘unexplained by organic disease’ in 1144 new neurology out-patients: how often does the diagnosis change at follow-up? Brain. 2009; 132:2878-88.
48. Gask L, Dowrick C, Salmon P, Peters S, Morriss R. Reattribution reconsidered: narrative review and reflections on an educational intervention for medically unexplained symptoms in primary care settings. J Psychosom Res. 2011; 71: 325-34.
49. Skovenborg EL, Schro¨der A. Is physical disease missed in patients with medically unexplained symptoms? A long-term follow-up of 120 patients diagnosed with bodily distress syndrome. Gen Hosp Psychiatry. 2014; 36:38-45.
50. Brody DS, Miller SM, Lerman CE, Smith DG, Caputo GC. Patient perception of involvement in medical care: relationship to illness attitudes and outcomes. J Gen Intern Med. 1989; 4:506-11. [PMID: 2585158]
51. Kroenke K, Jackson JL. Outcome in general medical patients presenting with common symptoms: a prospective study with a 2-week and a 3-month follow-up. Fam Pract. 1998; 15:398-403. [PMID: 9848423]
52. Speckens AE, Van Hemert AM, Bolk JH, Rooijmans HG, Hengeveld MW. Unexplained physical symptoms: outcome, utilization of medical care and associated factors. Psychol Med. 1996; 26:745-52. [PMID: 8817709]
53. Jackson JL, Passamonti M. The outcomes among patients presenting in primary care with a physical symptom at 5 years. J Gen Intern Med. 2005; 20:1032-7.
54. Olde Hartman TC, Borghuis MS, Lucassen PL, van de Laar FA, Speckens AE, van Weel C. Medically unexplained symptoms, somatisation disorder and hypochondriasis: course and prognosis. A systematic review. J Psychosom Res. 2009; 66:363-77.
55. Salmon P. The potentially somatizing effect of clinical consultation. CNS Spectr. 2006; 11:190-200. [PMID: 16575376]
56. Smith RC, Lein C, Collins C, Lyles JS, Given B, Dwamena FC, et al. Treating patients with medically unexplained symptoms in primary care. J Gen Intern Med. 2003; 18:478-89. [PMID: 12823656]
57. Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet. 2007; 369:946-55. [PMID: 17368156]
58. Rao JK, Weinberger M, Kroenke K. Visit-specific expectations and patient centered outcomes: a literature review. Arch Fam Med. 2000; 9:1148-55.
59. Jackson JL, Kroenke K. The effect of unmet expectations among adults presenting with physical symptoms. Ann Intern Med. 2001; 134:889-97.
60. Kravitz RL. Measuring patients’ expectations and requests. Ann Intern Med. 2001; 134:881-8. [PMID: 11346324]
61. Dowrick CF, Ring A, Humphris GM, Salmon P. Normalisation of unexplained symptoms by general practitioners: a functional typology. Br J Gen Pract. 2004; 54:165-70. [PMID: 15006120]
62. Jackson JL, O’Malley PG, Kroenke K. Antidepressants and cognitive behavioral therapy for symptom syndromes. CNS Spectr. 2006; 11:212-22.
63. Kelley GA, Kelley KS, Hootman JM, Jones DL. Effects of community deliverable exercise on pain and physical function in adults with arthritis and other rheumatic diseases: a meta-analysis. Arthritis Care Res (Hoboken). 2011; 63:79-93.
64. McMillan EM, Newhouse IJ. Exercise is an effective treatment modality for reducing cancer-related fatigue and improving physical capacity in cancer patients and survivors: a meta-analysis. Appl Physiol Nutr Metab. 2011; 36:892-903.
65. Daley A. Exercise and depression: a review of reviews. J Clin Psychol Med Settings. 2008; 15:140-7. [PMID: 19104978] doi:10.1007/s10880-008-9105-z
66. Herring MP, O’Connor PJ, Dishman RK. The effect of exercise training on anxiety symptoms among patients: a systematic review. Arch Intern Med. 2010;170:321-31. [PMID: 20177034] doi:10.1001/archinternmed.2009.530
67. Abbass A, Kisely S, Kroenke K. Short-term psychodynamic psychotherapy for somatic disorders. Systematic review and meta-analysis of clinical trials. Psychother Psychosom. 2009; 78:265-74.
68. Lakhan SE, Schofield KL. Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis. PLoS One. 2013; 8:e71834. [PMID: 23990997] doi:10.1371/journal.pone.0071834
69. Tan G, Craine MH, Bair MJ, Garcia MK, Giordano J, Jensen MP, et al. Efficacy of selected complementary and alternative medicine interventions for chronic pain. J Rehabil Res Dev. 2007; 44:195-222. [PMID: 17551873]
70. Morris DW, Trivedi MH. Measurement-based care for unipolar depression. Curr Psychiatry Rep. 2011; 13:446-58.
71. Kroenke K. Enhancing the clinical utility of depression screening. CMAJ. 2012; 184:281-2. [PMID: 22231681] doi:10.1503/cmaj.112004
72. Kroenke K, Spitzer RL, Williams JB, Lo¨we B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry. 2010; 32:345-59.
73. Zijlema WL, Stolk RP, Lo¨we B, Rief W, White PD, Rosmalen JG; BioSHaRE. How to assess common somatic symptoms in large-scale studies: a systematic review of questionnaires. J Psychosom Res. 2013; 74:459-68.
74. Gierk B, Kohlmann S, Kroenke K, Spangenberg L, Zenger M, Bra¨hler E, et al. The somatic symptom scale-8 (SSS-8): a brief measure of somatic symptom burden. JAMA Intern Med. 2014; 174:399-407.
75. Johns SA, Kroenke K, Theobald DE, Wu J, Tu W. Telecare management of pain and depression in patients with cancer: patient satisfaction and predictors of use. J Ambul Care Manage. 2011;34:126-39.

 

Comentarios

Para ver los comentarios de sus colegas o para expresar su opinión debe ingresar con su cuenta de IntraMed.

AAIP RNBD
Términos y condiciones de uso | Política de privacidad | Todos los derechos reservados | Copyright 1997-2024