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PhD ceremony Mr. P.H. Hilderink: Medically unexplained symptoms in later life

When:We 05-02-2014 at 12:45
Where:Academiegebouw, Broerstraat 5, Groningen

PhD ceremony: Mr. P.H. Hilderink

Dissertation: Medically unexplained symptoms in later life

Promotor(s): prof. R.C. Oude Voshaar, prof. J.G.M. Rosmalen

Faculty: Medical Sciences

The aim of this thesis is to increase the knowledge of the prevalence, the clinical presentation and the consequences of Medically Unexplained Symptoms (MUS) in later life. It is well known that the prevalence of MUS is high in the younger adult population, and they cause a high burden both for patients and health care services, but MUS in later life have been neglected.

A systematic review, a clinical sample of older MUS patients, and data from a longitudinal and a cross-sectional population based study, we study MUS in later life.

Our review of the literature showed that MUS are present in later life, but the prevalence rate of MUS declines beyond the age of 65. This is partly due to the fact that medical symptoms in later life are more readily interpreted as depression or co-morbid somatic disorder. Many older patients with MUS have co-morbid depressions and the presence of chronic pain increases the risk of developing a depression. The high presence of medically explained symptoms in later life results in more partially explained MUS in later life compared with younger MUS patients. The negative impact of MUS on the experienced quality of life decreases in later life. This suggest that older persons adapt better to MUS or that MUS are often milder in later life.

Older patients with MUS have high prevalence rates of co-morbid somatic diseases and psychiatric disorders and therefore a multidisciplinary approach is warranted.

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