Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis
Abstract Background A significant proportion of individuals with suspicious onset of multiple sclerosis (MS) does not fulfill the diagnostic criteria. Although some receive other diagnoses, many remain undiagnosed and lack healthcare follow‐up. This study aimed to characterize persons with undetermi...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.3459 |
| _version_ | 1827308795785641984 |
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| author | Lenka Novakova Anna Karin Hedström Markus Axelsson Anne Frandsen Brandt Lars Alfredsson Tomas Olsson Jan Lycke |
| author_facet | Lenka Novakova Anna Karin Hedström Markus Axelsson Anne Frandsen Brandt Lars Alfredsson Tomas Olsson Jan Lycke |
| author_sort | Lenka Novakova |
| collection | DOAJ |
| description | Abstract Background A significant proportion of individuals with suspicious onset of multiple sclerosis (MS) does not fulfill the diagnostic criteria. Although some receive other diagnoses, many remain undiagnosed and lack healthcare follow‐up. This study aimed to characterize persons with undetermined diagnosis (PwUD) through a questionnaire. Methods Incident cases with suspected MS were consecutively admitted to a tertiary neurological healthcare center in a prospective cohort study. Those who remained undiagnosed after 40 months (mean, range 31–52) were considered PwUD. They completed a modified questionnaire, previously used in a population‐based case‐control study of incident MS cases. Their responses were compared with two control cohorts, persons with MS (PwMS) and healthy controls, randomly selected from national registries, matched by age, gender, and area of residence. Results Out of 271 patients with suspected MS onset, 72 (20.3%) were PwUD with a female majority (79%). The response rate was 83% and 39% reported persisting MS‐like symptoms. Compared to controls (n = 548) and PwMS (n = 277), fewer PwUD were currently smoking (p = .4 and p = .03), consumed less alcohol (p = .04 and p = .01), and had children (p = .02 and p = .002). PwUD reported occurrence of other autoimmune disease in 29%, higher compared to PwMS and controls (p < .001 and p < .001). Conclusions UD is common among persons investigated for suspected MS, in particular among female parents. Our data suggest that PwUD can be characterized as nonsmokers with low alcohol consumption and a higher prevalence of autoimmune disease, in particular thyroid disease. |
| first_indexed | 2024-04-24T19:16:58Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-04-24T19:16:58Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-fc59ed666d324f91830d1944a59b9bee2024-03-26T05:06:44ZengWileyBrain and Behavior2162-32792024-03-01143n/an/a10.1002/brb3.3459Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosisLenka Novakova0Anna Karin Hedström1Markus Axelsson2Anne Frandsen Brandt3Lars Alfredsson4Tomas Olsson5Jan Lycke6Department of Clinical Neuroscience, Institute of Neuscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenDepartment of Clinical Neuroscience Karolinska Institute Stockholm SwedenDepartment of Clinical Neuroscience, Institute of Neuscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenDepartment of Clinical Neuroscience, Institute of Neuscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenDepartment of Clinical Neuroscience Karolinska Institute Stockholm SwedenDepartment of Clinical Neuroscience Karolinska Institute Stockholm SwedenDepartment of Clinical Neuroscience, Institute of Neuscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenAbstract Background A significant proportion of individuals with suspicious onset of multiple sclerosis (MS) does not fulfill the diagnostic criteria. Although some receive other diagnoses, many remain undiagnosed and lack healthcare follow‐up. This study aimed to characterize persons with undetermined diagnosis (PwUD) through a questionnaire. Methods Incident cases with suspected MS were consecutively admitted to a tertiary neurological healthcare center in a prospective cohort study. Those who remained undiagnosed after 40 months (mean, range 31–52) were considered PwUD. They completed a modified questionnaire, previously used in a population‐based case‐control study of incident MS cases. Their responses were compared with two control cohorts, persons with MS (PwMS) and healthy controls, randomly selected from national registries, matched by age, gender, and area of residence. Results Out of 271 patients with suspected MS onset, 72 (20.3%) were PwUD with a female majority (79%). The response rate was 83% and 39% reported persisting MS‐like symptoms. Compared to controls (n = 548) and PwMS (n = 277), fewer PwUD were currently smoking (p = .4 and p = .03), consumed less alcohol (p = .04 and p = .01), and had children (p = .02 and p = .002). PwUD reported occurrence of other autoimmune disease in 29%, higher compared to PwMS and controls (p < .001 and p < .001). Conclusions UD is common among persons investigated for suspected MS, in particular among female parents. Our data suggest that PwUD can be characterized as nonsmokers with low alcohol consumption and a higher prevalence of autoimmune disease, in particular thyroid disease.https://doi.org/10.1002/brb3.3459autoimmune disorderepidemiologicalfunctional disordermedically unexplained symptomsmultiple sclerosissurvey |
| spellingShingle | Lenka Novakova Anna Karin Hedström Markus Axelsson Anne Frandsen Brandt Lars Alfredsson Tomas Olsson Jan Lycke Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis Brain and Behavior autoimmune disorder epidemiological functional disorder medically unexplained symptoms multiple sclerosis survey |
| title | Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis |
| title_full | Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis |
| title_fullStr | Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis |
| title_full_unstemmed | Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis |
| title_short | Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis |
| title_sort | medically unexplained symptoms are common in women in tertiary neurological healthcare center a survey cohort study of persons investigated for suspected multiple sclerosis |
| topic | autoimmune disorder epidemiological functional disorder medically unexplained symptoms multiple sclerosis survey |
| url | https://doi.org/10.1002/brb3.3459 |
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