Medically unexplained symptoms--GPs' attitudes towards their cause and management

Reid, Steven; Whooley, David; Crayford, Tim; Hotopf, Matthew

doi:10.1093/fampra/18.5.519

Cited by 136 publications

(106 citation statements)

References 7 publications

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“…GPs generally feel that patients with medically unexplained symptoms are difficult to manage (Reid et al, 2001b), and they feel ill-equipped to deal with and treat these patients (Wileman et al, 2002). SFD patients' demands for emotional support seem to be particularly challenging Salmon et al, 2005).…”

Section: Clinical Implications: Diagnosis and Treatmentmentioning

confidence: 99%

Somatoform disorders and causal attributions in patients with suspected allergies: Do somatic causal attributions matter?

Groben¹,

Hausteiner²

2011

Journal of Psychosomatic Research

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Section: Clinical Implications: Diagnosis and Treatmentmentioning

confidence: 99%

Somatoform disorders and causal attributions in patients with suspected allergies: Do somatic causal attributions matter?

Groben¹,

Hausteiner²

2011

Journal of Psychosomatic Research

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“…This entails a significant financial and structural impact on health care (Reid et al, 2002;Woivalin et al, 2004), generates inappropriate referrals and treatment (Salmon et al, 2006) (Mayou and Sharpe, 1997), engenders physician frustration (Reid et al, 2001;Salmon et al, 2005;Ringsberg and Krantz, 2006), and of course, results in distress for the patient who generally consults with the hope of identifying an explanation and concordant cure (Malterud, 2000;Katon et al, 2001;Nettleton, 2006). One of Nettleton's interviewees explained: 'There is a lurking fear -in the dark out there that I may be faking it.…”

Section: Introductionmentioning

confidence: 99%

Medically unexplained symptoms and the disease label

Jutel

2010

Soc Theory Health

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Medically unexplained symptoms are a source of frustration for clinician and patient alike. They simultaneously test the credibility of the doctor and the patient; the former, for his or her inability to label the patient's complaint, and the latter, for the ignominy of being perceived to have a factitious symptom. This review explores the discursive construction of such symptoms in the medical literature in order to appreciate the context in which medicine understands and manages non-diagnosed complaints. It uses medically unexplained symptoms as a heuristic for understanding the role of classification in constituting medicine as a social authority. In the absence of diagnostic category, medically unexplained symptoms are recast as a discrete category of their own. However, this category implies the infallibility of the physician and the relevance of the medical model in all circumstances. It transfers responsibility for the disorder to the patient in a way that may hinder resolution, and it ignores socio-historical practices that influence when and why patients consult a physician.

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“…Furthermore, somatizing patients do not readily accept referral for psychological treatments. GPs must be capable of assessing and treating most somatizing patient within the primary care setting and they also express a wish to do so [22,23].…”

Section: Treatment Of Somatizationmentioning

confidence: 99%

Somatization, heartsink patients, or functional somatic symptoms? Towards a clinical useful classification in primary health care

Rosendal

Fink

Bro

et al. 2005

Scandinavian Journal of Primary Health Care

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Several definitions of somatization exist and try to deal with the fundamental problem that a large group of patients present with physical symptoms for which a conventional pathology cannot be identified. However, the concept remains somewhat confusing. The prevalence of somatization is high in general practice. Nevertheless, patients do not receive proper treatment and risk iatrogenic somatic fixation and harm, the doctor Á/patient relationship is often negatively affected and the overall healthcare system suffers from high expenditure on unnecessary physical investigations and treatments. During the last decade research has shown that somatization may be treated effectively in specialist care. Little is known about effective treatment in primary care but the Reattribution Model and the Extended Reattribution and Management Model have shown promising results. The development and evaluation of new treatment strategies is, however, hampered by the confusion of definitions and concepts. In this article an overview is presented of the various concepts relevant to the clinical work and research in primary health care. It is important to realize that somatizing patients in primary health care present a broader spectrum of severity than patients seen in a specialist setting. Hence, primary care cannot apply definitions from specialist care directly but needs a definition that also includes the mild cases. We need classifications and agreed definitions applicable in primary health care in order to develop appropriate management strategies, to predict prognosis, and to enable rigorous research concerning the large group of somatizing patients in primary health care.

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Medically unexplained symptoms--GPs' attitudes towards their cause and management

Abstract: GPs consider the management of patients with MUS to be an important part of their workload, but there is a perception that effective management strategies are lacking. Psychiatrists need to offer greater support and training for GPs in this area of health care.

Cited by 136 publications

References 7 publications

Somatoform disorders and causal attributions in patients with suspected allergies: Do somatic causal attributions matter?

Somatoform disorders and causal attributions in patients with suspected allergies: Do somatic causal attributions matter?

Medically unexplained symptoms and the disease label

Somatization, heartsink patients, or functional somatic symptoms? Towards a clinical useful classification in primary health care

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