Medically unexplained symptoms and psychological problems before and after disasters.

Yzermans, C.J., Berg, B. van den. Medically unexplained symptoms and psychological problems before and after disasters. European Journal of Public Health: 2007, 17(suppl. 2) 97. Abstract. 15th Annual EUPHA Meeting: "The future of public health in the Unified Europe", Helsinki, 11-13 oktober 2007.
Background: Medically unexplained symptoms (MUS) may be a major public health problem, especially after disasters. What is the course of MUS in the aftermath of a disaster? Is there a difference between self-reported symptoms and those presented to the general practitioner (GP)? Is there an association between MUS and psychological problems? Methods: Data was collected in the context of two Dutch disasters, the Bijlmermeer plane crash (1992) and the Enschede fireworks disaster (2000). Research after the Bijlmermeer disaster was carried out retrospectively, based on self-report to a call center and compared to GP records. Research after the Enschede disaster was also based on self-report (questionnaires) and GP records. In the Enschede study pre-disaster GP data was available. Results: Almost all symptoms presented after the plane crash were unexplained. One out of eight symptoms was already known to the GP before the disaster and 16% of symptoms were presented 5–6 years post-disaster, during a media hype. According to the GPs, only 6% of the symptoms were directly related to the disaster. Self-reported symptoms after the fireworks disaster were likely to remain unexplained (57–91%) and only a minority was presented to the GP, although persistent symptoms were more often presented. The number of symptoms presented to the GP had increased in the first two years post-disaster. A high level of post-disaster MUS was associated with a high number of pre-disaster MUS (OR 5.5), with pre-disaster GP contacts (1.8) and with concurrent psychological problems (3.9). Until four years post-disaster the correlations between MUS and psychological problems were statistically significant among survivors. Conclusions: The risk of increased and persistent numbers of MUS is higher after a tumultuous aftermath of a disaster (Bijlmermeer, media hype). In survivors, MUS and psychological problems were significantly correlated for many years.(aut. ref.)