Characteristics of outpatients with functional somatic syndromes at a university hospital's general medicine clinic, 2022, Nishiyama et al

Abstract

Background
The term medically unexplained symptoms (MUS) is unhelpful for both patients and physicians, and more acceptable illness categories are needed as substitutes for MUS. While some potential substitutes are characterized by excessive psychological burden related to somatic symptoms, “functional somatic syndromes” (FSS) is a category that focuses on physical dysfunction and emphasizes similarities among individual syndromes. Examples of FSS include irritable bowel syndrome, functional dyspepsia, and fibromyalgia syndrome. This study aimed to distinguish FSS from MUS and compare the somatic and psychobehavioral characteristics of FSS with those of other diseases.

Methods
This study included 1975 first-visit outpatients at a Japanese university hospital's general medicine clinic. According to their first-listed diagnosis, they were classified as having FSS, acute infection, organic disease (OD), psychiatric disorder, and unknown condition (UC). The somatic symptom burden and health-related quality of life (HRQoL) were assessed using the Somatic Symptom Scale-8 and EuroQol-5 Dimension, respectively; the involvement of psychobehavioral factors affecting somatic symptoms was also evaluated.

Results
Overall, 33% of patients were included in the FSS category, and 93% of the supposed MUS (FSS and UC) were diagnosed with FSS. Compared with OD, FSS showed more severe somatic symptom burden, similar reduced HRQoL, and higher involvement of psychobehavioral factors.

Conclusion
It can be useful to improve FSS diagnostic skills for the reduction of MUS misdiagnosis. Psychobehavioral factors might be less associated with MUS (in the narrow sense of the term) than FSS.

Open access, https://onlinelibrary.wiley.com/doi/10.1002/jgf2.543

 

It's getting hard to accept this isn't some weird twisted parody. They literally can't discuss the issue with intelligence because they have to "accept" premises that are so obviously nonsense that all discussion that follows can only be nonsense.

You can't build a category out of "things we don't understand". It literally contains most things and is constantly shifting with time (and place, this "category" is different everywhere because no one is at the same level of technological development at the same time).

It's also not a property of the patients or the symptoms, it's strictly a relation property from the perspective of the physician. It doesn't even define those symptoms, only the position of the physician who doesn't have the technology or knowledge to deal with them. Yet.

It's as foolish as a physicist insisting that "down" is this way, where they point down from their frame of reference. And getting into a screaming match that it obviously can only be "down" since objects fall "down" in this direction. It's a blessing other fields of science aren't subject to their own mythology because we'd be so screwed as a species.

This is all junk pseudoscience and it's destroying lives while these fools obsess over labels and irrelevant issues.