Medically unexplained physical symptoms in Latino primary care patients: A descriptive analysis of psychiatric comorbidity and the association of physical symptoms with psychopathology and physical impairment.

摘要

This study describes the clinical characteristics of Latino patients who seek services for medically unexplained physical symptoms (MUPS) in primary care clinics. MUPS are extremely common in primary care and represent an impairing, costly, and frustrating problem. The prevalence of MUPS in Latinos is believed to be especially high. The aim of this study was to investigate the prevalence of psychological symptoms, mental health disorders, rates of physical functioning, and the associations among these variables in a sample of Latino primary care patients with MUPS. The sample was comprised of 85 self-identified Latino, medical outpatients who sought medical services in two urban primary care clinics in Central New Jersey and who were referred by their physicians to a clinical trial of a specialized psychotherapy designed to treat patients with MUPS. Patients were assessed by bilingual (Spanish/English) clinicians using structured clinical interview measures. Participants were largely female, unmarried, born in Latin America, and with low educational levels. The study results suggest that Latino patients with MUPS in primary care represent a population that suffers from high levels of psychological distress in the form of anxiety and depression symptoms, most meet criteria for DSM-IV mood and anxiety disorders, and exhibit low levels of physical functioning. In addition, the general number of MUPS reported by patients predicted the likelihood of having a psychiatric disorder, and was positively correlated with levels of psychological distress and physical impairment. A clinical implication of these findings is that primary care clinicians can consider MUPS as predictors of psychiatric disorders, psychological distress, and physical impairment when working with this population. Specific recommendations for the treatment of Latino patients with MUPS are discussed.