Latent profile analysis of biopsychosocial measures in older patients with (un)explained persistent somatic symptoms 2024 Bos et al

Andy

Andy

Retired committee member
Highlights

  • We identified two somatic-health and four mental-health based profiles.

  • We found no association between somatic – and mental-health based profiles.

  • Health related quality of life negatively associated with vulnerable profiles.

  • Unintegrated care may lead to undertreatment of the most vulnerable patients.

Abstract

Patients with persistent somatic symptoms (PSS) often receive either somatic or psychiatric care, depending on whether symptoms are respectively medically explained (MES) or unexplained (MUS). This separation may not be as clinically relevant as previously assumed; however, research on data-driven subgroups within cohorts of older patients with PSS is not available. Our goal is to identify more clinically relevant homogeneous subgroups beyond the distinction of MUS and MES among older patients with PSS by using a data-driven approach.

We performed two Latent Profile Analyses (LPAs), one focused on 6 somatic health measures, the other on 6 psychosocial measures, using data from a case-control study with participants (>60 years) with MUS (N = 118) or MES (N = 154), recruited from the general public, general practices and secondary healthcare. We identified two somatic-health based (strong, vulnerable) and four mental-health based (strong, vulnerable, lonely, non-acceptance) profiles.

We found no statistically significant overlap between the somatic – and mental health profiles (κ = 0.019). Health related quality of life negatively associated with the mentally – and somatically vulnerable profiles. We conclude that singular focus on MUS/MES distinction in the care for older PSS patients may lead to undertreatment of the most vulnerable patients. Integrated care is recommended when treating persistent somatic symptoms in later life, regardless of the (un)explained origin of the symptoms.

Open access, https://www.sciencedirect.com/science/article/pii/S0010440X24000786
 
So rather than confirming if either is good enough to start with given some of the stories we’ve now heard of sub appropriate hospital care

they focused on comparing the two suggesting merging them on basis those who had explained symptoms getting that were equally something in a quality of life to those who apparently had Mus (or did that include psychiatric illnesses too?) and were treated via that

but how long after and how much was just politeness that the doctor seemed to have done their best and I’m sure it was the right thing , I’m getting old anyway parts will fall off so if he/says it won’t get better with treatment…..

theres a certain vulnerable mindset with old people’s relationships with docs and I’m worried what they were actually measuring and what people were really answering on
 
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Sean said:
Integrated care is recommended when treating persistent somatic symptoms in later life, regardless of the (un)explained origin of the symptoms.

BPS for everything.
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It’s basically calling a bit of gaslighting ‘medical care’ or redefining what counts as ‘we offered care’ isn’t it

no longer investigating nevermind treat and different staff

not healthcare for all as their papers seem to contain hidden or not so hidden messages about who to target , listing the vulnerable with an excuse why they can get away with it fir those

it really is all about them programming fibs into the politicians and service that free at point of delivery is being abused so they are snowed under and

pretending the issue is they are snowed under by swathes of this type who can be fobbed off with permission from .. society? Their boss? These articles to muddy their legal position? …. To non treatment and they won’t notice

except people forget the staff for all this might have a cushy number but they aren’t coming for free just like all the nasty propaganda research

and the reason they are short staffed or resourced is lack of staff and funding, often untreated illness so this cures nothing . So these people aren’t their heroes - they are carving off funding that could be going on proper decent care being planned for all
 
This reads so oddly. I've only read the abstract.

It's a wonder some people are walking around in the Netherlands who think like this. Quite, quite bizarre. Canteen chat must be scintillating ;)

Essentially trying to suggest they can make some kinda sense of the heterogeneous mess that is MUS by identifying homogeneous subgroups. The mind boggles.
 
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