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A Follow-up Study of Patients with Medically Unexplained Symptoms Referred to a Liaison Psychiatry Service

Objective: The principal objective was to describe general hospital use and mortality in a group of patients with medically unexplained symptoms referred to a liaison psychiatry service. Method: Cases were identified from patients with medically unexplained symptoms referred to a liaison psychiatry service between 1998 and 2005. We also identified a control group of patients, matched for age, sex, and date of referral, referred for other reasons to the same service. Follow-up information was obtained from the New Zealand Health Information Service national minimum data set from 1998 to 2006. Finally we compared hospital use in people with medically unexplained symptoms with national data on average length of stay in New Zealand hospitals. Results: Over 9 years 153 patients referred for medically unexplained symptoms spent nearly 14,000 days in hospital. They also had statistically significant greater numbers of general hospital admissions and fewer deaths compared to patients referred to liaison psychiatry for other reasons. Patients with medically unexplained symptoms spent 41% spent longer in hospital on each admission (5.5 days) compared to the New Zealand average length of stay in general hospitals (3.9 days). After referral to liaison psychiatry patients who were frequently admitted with medically unexplained symptoms experienced a statistically significant decrease in the number of admissions and length of stay per year. Conclusions: Patients referred to a liaison psychiatry service with medically unexplained symptoms use substantial amounts of health service resources. They also have a lower mortality and are admitted to hospital more often than a matched control group.