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Disability, distress and unemployment in neurology outpatients with symptoms 'unexplained by organic disease'

Citation
Carson AJ, Stone JC, Hibberd C, Murray G, Duncan RDD, Coleman RJ, Warlow CP, Roberts RC, Pelosi AJ, Cavanagh JTO, Matthews KB, Goldbeck R, Hansen CH & Sharpe MC (2011) Disability, distress and unemployment in neurology outpatients with symptoms 'unexplained by organic disease', Journal of Neurology, Neurosurgery, and Psychiatry, 82 (7), pp. 810-813.

Abstract

Objectives: To determine the disability, distress and employment status of new neurology outpatients with physical symptoms unexplained by organic disease and to compare them with patients with symptoms explained by organic disease.

Methods: As part of a cohort study (the Scottish Neurological Symptoms Study) neurologists rated the extent to which each new patient's symptoms were explained by organic disease. Patients whose symptoms were rated as 'not at all' or only 'somewhat' explained by disease were considered cases, and those whose symptoms were 'largely' or 'completely' explained by disease were considered controls. All patients completed self-ratings of disability, health status (Medical Outcomes Study Short Form 12-Item Scale (SF-12)) and emotional distress (Hospital Anxiety and Depression Scale) and also reported their employment and state financial benefit status.

Results: 3781 patients were recruited: 1144 (30%) cases and 2637 (70%) controls. Cases had worse physical health status (SF-12 score 42 vs 44; difference in means 1.7 (95% CI e2.5 to 0.9)) and worse mental health status (SF-12 score 43 vs 47; difference in means e3.5 (95% CI e4.3 to to 2.7)). Unemployment was similar in cases and controls (50% vs 50%) but cases were more likely not to be working for health reasons (54% vs 37% of the 50% not working; OR 2.0 (95% CI 1.6 to 2.4)) and also more likely to be receiving disability-related state financial benefits (27% vs 22%; (OR 1.3, 95% CI 1.1 to 1.6)).

Conclusions: New neurology patients with symptoms unexplained by organic disease have more disability-, distress- and disability-related state financial benefits than patients with symptoms explained by disease.

Subject headings
Medicine;Neurosciences;Neurology.

StatusPublished
AuthorsCarson Alan J, Stone Jon C, Hibberd Carina, Murray Gordon, Duncan Roderick D D, Coleman Richard J, Warlow Charles P, Roberts Richard C, Pelosi Anthony J, Cavanagh Jonathan T O, Matthews Keith B, Goldbeck Rainer, Hansen Christian Holm, Sharpe Michael C
Publication date07/2011
PublisherBMJ Publishing Group
ISSN 0022-3050
LanguageEnglish

Journal
Journal of Neurology, Neurosurgery, and Psychiatry: Volume 82, Issue 7 (JUL 2011)

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