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Medically Unexplained Symptoms in an Urban General Medicine Practice

Received August 25, 2000; accepted December 5, 2000. From the Division of Clinical and Genetic Epidemiology, Department of Psychiatry, and the Division of General Medicine, Department of Internal Medicine, College of Physicians and Surgeons; Joseph L. Mailman School of Public Health, Columbia University; New York State Psychiatric Institute, New York, New York; and Psychology Department, Montclair State University, Upper Montclair, New Jersey. Address correspondence Dr. Feder, Division of Clinical and Genetic Epidemiology, Department of Psychiatry, Columbia University, 1051 Riverside Drive — Unit 24, New York, NY 10032; e-mail: af286{at}columbia.edu

The authors investigated the prevalence of multiple medically unexplained symptoms (MMUS) as identified by primary care physicians (PCPs) in a systematic sample of 172 patients. Patients were from a university-affiliated urban primary care practice serving a low-income population. Patients with a history of MMUS were older (mean: 57.2 vs. 53.0 years), more likely to be female (90.5% vs. 72.3%), and less likely to be married or living with a partner (14.4% vs. 36.2%) than those without MMUS. Patients with MMUS had over twice the rate of any current psychiatric disorder, almost two-and-a-half times the rate of any current anxiety disorder, and greater functional impairment. These data suggest that patients with MMUS are as common in urban primary care clinics as in more affluent clinics and reinforce the need for PCPs to screen these patients for common and treatable psychiatric conditions.

Key Words: Medically Unexplained Symptoms • Primary Care Physicians • Urban Clinics

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