History of Functional Somatic Syndromes and Persistent Symptoms After Mild Traumatic Brain Injury, 2020, Silverberg et al

Andy

Andy

Retired committee member
Objective:
Somatization is thought to underlie functional somatic syndromes (FSSs) and may also contribute to prolonged symptoms after mild traumatic brain injury (mTBI). The investigators evaluated the prevalence of FSSs in patients seeking specialty care after mTBI and whether a history of FSSs was associated with symptom persistence.

Methods:
A total of 142 patients with mTBI completed questionnaires regarding demographic information, injury characteristics, and medical history, including history of diagnosed FSSs at clinic intake (mean=41 days postinjury [SD=22.41]). Postconcussion symptoms were assessed at clinic intake and again 1 and 3 months later. A linear mixed-effects model was used to determine whether history of FSSs was related to persistent mTBI symptoms over time.

Results:
A history of at least one FSS was reported by 20.4% of patients. In the linear mixed model, postconcussion symptom scores were not significantly different over time among patients with a history of one or more FSSs or two or more FSSs from those with no FSSs. A history of one or more FSSs or two or more FSSs (versus no FSS) was not associated with increased odds of severe postconcussion symptoms at clinic intake (one or more FSSs: odds ratio=0.88, 95% CI=0.38–2.03; two or more FSSs: odds ratio=1.78, 95% CI=0.45–7.03), at the 1-month follow-up visit (one or more FSSs: odds ratio=0.57, 95% CI=0.22–1.45; two or more FSSs: odds ratio=0.57, 95% CI=0.14–2.37), or at the 3-month follow-up visit (one or more FSSs: odds ratio=0.97, 95% CI=0.36–2.63; two or more FSSs: odds ratio=1.27, 95% CI=0.29–5.65).

Conclusions:
In this sample, the prevalence rates of FSSs were higher than rates previously reported for the general population. However, FSS history did not predict higher postconcussion symptom burden at clinic intake or persistence over the following 3 months. Further research is needed to clarify the potential role of somatization in poor mTBI outcome.
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Paywall, https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.20060159
Sci hub, no access.
 
One wonders about misdiagnosis in all subtypes of FSS which is still occurring in Conversion Disorder:

"Misdiagnosis of an underlying medical condition as Conversion Disorder/Functional Neurological Disorder (CD/FND) still occurs." 2020. C.M.van der Feltz-Cornelis

"Our findings show that misdiagnosis of an underlying medical condition as CD/FND still occurs in chronic cases within the specialist mental health setting. Large scale interdisciplinary research studies with collaborating psychiatrists and neurologists are required to confirm these findings and to contribute to the re-evaluation of guidelines for assessment of CD/FND. Also, these findings warrant the serious consideration of diagnostic re-evaluations in chronic cases. There is a clear call for structurally embedding somatic re-examination and reevaluation in specialist mental health settings, by consultation liaison and integrated care models which involve psychiatrists, referring neurologists and primary care physicians. Such a provision, that has shown to be beneficial at case level [13], is unfortunately not currently widely available. Policymakers should support the development of such sus- tainable somatic evaluation facilities and services."

https://www.sciencedirect.com/science/article/abs/pii/S0163834320300645?via=ihub
Sci-Hubhttps://sci-hub.se - doi.org/10.1016/j.genhosppsych.2020.05.003
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https://www.s4me.info/threads/misdi...-fnd-2020-van-der-feltz-cornelis-et-al.15324/
 
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not giving doctors the ability to refuse to do their damn jobs may be all it takes to remove this totally fallacious excuse . just because the correct testing and referral to some one with a better understanding of various symptoms cost time and money . does not give them the right to jump to the god of the gaps eminence based thinking put out by professional illness deniers . i wonder how many doctors are deeply ashamed of the way supposedly modern medicine is being dragged/pushed back into the dark ages because of financial interest ie insurance and government bean counters . as soon as there ceases to be financial incentives to the parasites publishing endless copy pasted deeply flawed/ fraudulent papers the sooner we can return to actual scientific investigations of the amazingly complex human body .
 
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