What is the relationship between post-traumatic stress disorder and medically unexplained physical symptoms?

Downes, Anthony 2022. What is the relationship between post-traumatic stress disorder and medically unexplained physical symptoms? MD Thesis, Cardiff University. Item availability restricted.

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Abstract

Although post-traumatic stress disorder (PTSD) has been associated with medically unexplained physical symptoms (MUPS) more than any other psychiatric disorder, the comorbid prevalence of both conditions was unclear from the literature. Furthermore, the impact of co-morbid PTSD and MUPS on health and social care experiences was not evident. To address these gaps in knowledge, this thesis aimed to estimate the co-morbid prevalence of PTSD and MUPS, and to explore the health and social care experiences associated with both conditions. This was achieved through a systematic review and metaanalysis, and qualitative studies of both the patient journey, and the experiences of health and social care professionals who care for people with both conditions. Although there were limitations to all three studies, results indicated a close relationship between the two conditions. Findings suggested considerable co-morbidity and the devastating long-term impact of childhood trauma on adult wellbeing. Both patient/clients and professionals sought greater awareness and understanding of PTSD and MUPS through education and training. The importance of the therapeutic alliance and empathic relationships was identified, with a need for a psychodynamic approach alongside evidence-based care. The potential for conflict between patient/client and practitioner was also evident, with the need to mitigate ruptures of the therapeutic alliance. Both patients/clients and practitioners sought biopsychosocial, personalised care, although lack of service provision and resource constraints were identified. Furthermore, the burden of distress for both patients/clients and professionals was significantly increased by service deficits for PTSD and MUPS. Prevailing mind-body dualism, and fragmentation of service provision were considered as main barriers to providing integrated, holistic care. Although study limitations preclude generalisations, findings suggested further research was needed to help clarify issues identified in this thesis.

Item Type:	Thesis (MD)
Date Type:	Completion
Status:	Unpublished
Schools:	Medicine
Date of First Compliant Deposit:	8 November 2022
Last Modified:	06 Jan 2024 03:33
URI:	https://orca.cardiff.ac.uk/id/eprint/153879

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