Which neurological diseases are most likely to be associated with "symptoms unexplained by organic disease"

J. Stone, A. Carson, R. Duncan, R. Roberts, R. Coleman, C. Warlow, G. Murray, A. Pelosi, J. Cavanagh, K. Matthews, R. Goldbeck, M. Sharpe

    Research output: Contribution to journalArticle

    32 Citations (Scopus)

    Abstract

    Many patients with a diagnosis of neurological disease, such as multiple sclerosis, have symptoms or disability that is considered to be in excess of what would be expected from that disease. We aimed to describe the overall and relative frequency of symptoms 'unexplained by organic disease' in patients attending general neurology clinics with a range of neurological disease diagnoses. Newly referred outpatients attending neurology clinics in all the NHS neurological centres in Scotland, UK were recruited over a period of 15 months. The assessing neurologists recorded their initial neurological diagnoses and also the degree to which they considered the patient's symptoms to be explained by organic disease. Patients completed self report scales for both physical and psychological symptoms. The frequency of symptoms unexplained by organic disease was determined for each category of neurological disease diagnoses. 3,781 patients participated (91% of those eligible). 2,467 patients had a diagnosis of a neurological disease (excluding headache disorders). 293 patients (12%) of these patients were rated as having symptoms only "somewhat" or "not at all" explained by that disease. These patients self-reported more physical and more psychological symptoms than those with more explained symptoms. No category of neurological disease was more likely than the others to be associated with such symptoms although patients with epilepsy had fewer. A substantial proportion of new outpatients with diagnoses of neurological disease also have symptoms regarded by the assessing neurologist as being unexplained by that disease; no single neurological disease category was more likely than others to be associated with this phenomenon.

    Original languageEnglish
    Pages (from-to)33-38
    Number of pages6
    JournalJournal of Neurology
    Volume259
    Issue number1
    DOIs
    Publication statusPublished - 2012

    Keywords

    • Psychogenic
    • Functional overlay
    • Conversion disorder
    • Neurology outpatients
    • Non-organic
    • Somatoform
    • MULTIPLE-SCLEROSIS
    • UNITED-KINGDOM
    • MOTOR SYMPTOMS
    • OUT-PATIENTS
    • FOLLOW-UP
    • HYSTERIA
    • REFERRALS
    • DISORDERS
    • ILLNESS
    • CLINICS

    Cite this

    Stone, J., Carson, A., Duncan, R., Roberts, R., Coleman, R., Warlow, C., ... Sharpe, M. (2012). Which neurological diseases are most likely to be associated with "symptoms unexplained by organic disease". Journal of Neurology, 259(1), 33-38. https://doi.org/10.1007/s00415-011-6111-0
    Stone, J. ; Carson, A. ; Duncan, R. ; Roberts, R. ; Coleman, R. ; Warlow, C. ; Murray, G. ; Pelosi, A. ; Cavanagh, J. ; Matthews, K. ; Goldbeck, R. ; Sharpe, M. / Which neurological diseases are most likely to be associated with "symptoms unexplained by organic disease". In: Journal of Neurology. 2012 ; Vol. 259, No. 1. pp. 33-38.
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    abstract = "Many patients with a diagnosis of neurological disease, such as multiple sclerosis, have symptoms or disability that is considered to be in excess of what would be expected from that disease. We aimed to describe the overall and relative frequency of symptoms 'unexplained by organic disease' in patients attending general neurology clinics with a range of neurological disease diagnoses. Newly referred outpatients attending neurology clinics in all the NHS neurological centres in Scotland, UK were recruited over a period of 15 months. The assessing neurologists recorded their initial neurological diagnoses and also the degree to which they considered the patient's symptoms to be explained by organic disease. Patients completed self report scales for both physical and psychological symptoms. The frequency of symptoms unexplained by organic disease was determined for each category of neurological disease diagnoses. 3,781 patients participated (91{\%} of those eligible). 2,467 patients had a diagnosis of a neurological disease (excluding headache disorders). 293 patients (12{\%}) of these patients were rated as having symptoms only {"}somewhat{"} or {"}not at all{"} explained by that disease. These patients self-reported more physical and more psychological symptoms than those with more explained symptoms. No category of neurological disease was more likely than the others to be associated with such symptoms although patients with epilepsy had fewer. A substantial proportion of new outpatients with diagnoses of neurological disease also have symptoms regarded by the assessing neurologist as being unexplained by that disease; no single neurological disease category was more likely than others to be associated with this phenomenon.",
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    Stone, J, Carson, A, Duncan, R, Roberts, R, Coleman, R, Warlow, C, Murray, G, Pelosi, A, Cavanagh, J, Matthews, K, Goldbeck, R & Sharpe, M 2012, 'Which neurological diseases are most likely to be associated with "symptoms unexplained by organic disease"', Journal of Neurology, vol. 259, no. 1, pp. 33-38. https://doi.org/10.1007/s00415-011-6111-0

    Which neurological diseases are most likely to be associated with "symptoms unexplained by organic disease". / Stone, J.; Carson, A.; Duncan, R.; Roberts, R.; Coleman, R.; Warlow, C.; Murray, G.; Pelosi, A.; Cavanagh, J.; Matthews, K.; Goldbeck, R.; Sharpe, M.

    In: Journal of Neurology, Vol. 259, No. 1, 2012, p. 33-38.

    Research output: Contribution to journalArticle

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    AU - Stone, J.

    AU - Carson, A.

    AU - Duncan, R.

    AU - Roberts, R.

    AU - Coleman, R.

    AU - Warlow, C.

    AU - Murray, G.

    AU - Pelosi, A.

    AU - Cavanagh, J.

    AU - Matthews, K.

    AU - Goldbeck, R.

    AU - Sharpe, M.

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    N2 - Many patients with a diagnosis of neurological disease, such as multiple sclerosis, have symptoms or disability that is considered to be in excess of what would be expected from that disease. We aimed to describe the overall and relative frequency of symptoms 'unexplained by organic disease' in patients attending general neurology clinics with a range of neurological disease diagnoses. Newly referred outpatients attending neurology clinics in all the NHS neurological centres in Scotland, UK were recruited over a period of 15 months. The assessing neurologists recorded their initial neurological diagnoses and also the degree to which they considered the patient's symptoms to be explained by organic disease. Patients completed self report scales for both physical and psychological symptoms. The frequency of symptoms unexplained by organic disease was determined for each category of neurological disease diagnoses. 3,781 patients participated (91% of those eligible). 2,467 patients had a diagnosis of a neurological disease (excluding headache disorders). 293 patients (12%) of these patients were rated as having symptoms only "somewhat" or "not at all" explained by that disease. These patients self-reported more physical and more psychological symptoms than those with more explained symptoms. No category of neurological disease was more likely than the others to be associated with such symptoms although patients with epilepsy had fewer. A substantial proportion of new outpatients with diagnoses of neurological disease also have symptoms regarded by the assessing neurologist as being unexplained by that disease; no single neurological disease category was more likely than others to be associated with this phenomenon.

    AB - Many patients with a diagnosis of neurological disease, such as multiple sclerosis, have symptoms or disability that is considered to be in excess of what would be expected from that disease. We aimed to describe the overall and relative frequency of symptoms 'unexplained by organic disease' in patients attending general neurology clinics with a range of neurological disease diagnoses. Newly referred outpatients attending neurology clinics in all the NHS neurological centres in Scotland, UK were recruited over a period of 15 months. The assessing neurologists recorded their initial neurological diagnoses and also the degree to which they considered the patient's symptoms to be explained by organic disease. Patients completed self report scales for both physical and psychological symptoms. The frequency of symptoms unexplained by organic disease was determined for each category of neurological disease diagnoses. 3,781 patients participated (91% of those eligible). 2,467 patients had a diagnosis of a neurological disease (excluding headache disorders). 293 patients (12%) of these patients were rated as having symptoms only "somewhat" or "not at all" explained by that disease. These patients self-reported more physical and more psychological symptoms than those with more explained symptoms. No category of neurological disease was more likely than the others to be associated with such symptoms although patients with epilepsy had fewer. A substantial proportion of new outpatients with diagnoses of neurological disease also have symptoms regarded by the assessing neurologist as being unexplained by that disease; no single neurological disease category was more likely than others to be associated with this phenomenon.

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    KW - Conversion disorder

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    KW - Somatoform

    KW - MULTIPLE-SCLEROSIS

    KW - UNITED-KINGDOM

    KW - MOTOR SYMPTOMS

    KW - OUT-PATIENTS

    KW - FOLLOW-UP

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    KW - REFERRALS

    KW - DISORDERS

    KW - ILLNESS

    KW - CLINICS

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