Medically Unexplained Physical Symptoms in Elderly People: A Pilot Study of Psychiatric Geriatric Characteristics

Objective To examine the somatic complaints, functional impairment, and psychiatric comorbidity in elderly patients with medically unexplained symptoms (MUSs). Method A consecutive case series of 37 patients referred for MUS to a multidisciplinary, outpatient clinic at a secondary care mental health center in the Netherlands. All patients underwent a standardized examination by a geriatrician, psychiatrist, and psychologist. Results For three patients, a somatic explanation was found, and in two, their symptoms spontaneously resolved before a diagnosis could be made. Of the remaining 32 patients with MUS, depressive disorders were present in 18 (56%), anxiety disorders in 10 (31%), and substance use disorders in 6 patients (19%). Compared with nondepressed patients with MUS, depressed patients had more severe somatic symptoms, more psychological symptoms, and more functional impairment. Conclusions As the authors found a high comorbidity with other psychiatric disorders in elderly patients with MUSs, a systematic psychiatric examination should be part of their multidisciplinary assessment.