Somatic symptom disorders in hospitalized patients: clinical features and health care costs

Background and objectives. Somatic Symptoms Disorder (SSD), formerly known as somatoform disorder, is a mental disorder which manifests as physical symptoms that cannot be explained fully by a general medical condition. In current literature, Medically Unexplained Physical Symptoms (MUPS) are intended as physical symptoms without a medical explanation. The research provides for the collection of data from hospitalized patients presenting MUPS, aiming to draw a clinical and socio-demographic profile of these patients, to estimate economic costs related to hospital management, and to explore psychopathological correlates of SSD. Materials and methods. The cross-sectional study consists in the evaluation of data referring to all hospitalized patients admitted between 2008 and 2018 in the wards of a teaching hospital in Northern Italy. Results. Data referring to 273 hospitalized patients presenting MUPS have been detected. The sample shows a prevalence of female, married, and worker patients. The most frequent ward involved are Neurology, Internal Medicine and Short Unit Stay. The most common symptoms found are headache, pain, syncope and vertigo. The overall estimated cost of hospitalization for patients with MUPS is 475'409.73 €. No evidence that a history of medical disease is associated with a diagnosis of SSD. A personality disorder diagnosis in patients with MUPS is associated with increased probability of having a diagnosis of SSD. A marginally significant positive association also emerges with anxiety disorders, but not with depressive disorder. Conclusions. The research provides the investigation of a large number of patients with MUPS and a financial estimate of related hospitalization costs. Moreover, it allows to study clinical, socio-demographic and psychopathological correlates involved in SSD.