“…The shorthand statement 'difficult patient' thus seems to draw together 'difficulties' experienced by doctors vis-à-vis MUS patients in a variety of areas. According to Henningsen et al 's overview on barriers to improving treatment [61], these areas can broadly be described as context, comprising understanding of the condition and service organisation, and doctor-patient encounter, comprising doctor-related factors, patient-related factors and interaction-related factors. In a systematic review of barriers to diagnosis of "non-specific, functional, and somatoform disorders" in primary care, [66] through a grounded-theory approach Murray et al identified that barriers reported in the literature could be interpreted to fall under five very similar thematic categories, namely: patient-related barriers, primary-care physician (PCP) related barriers, interactional barriers, situational barriers, and conceptual and operational barriers.…”