Med/Psych Update

Medically unexplained physical symptoms: Evidence-based interventions

Current Psychiatry. 2011 July;10(7):17-32

References

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Related Resources

Burton C. Beyond somatization: a review of the understanding and treatment of medically unexplained physical symptoms. Brit J Gen Pract. 2003;53:233-239.
Creed F. The outcome of medically unexplained symptoms—will DSM-V improve on DSM-IV somatoform disorders? J Psychosom Res. 2009;66:379-381.
Katon W, Sullivan M, Walker E. Medical symptoms without identified pathology: relationship to psychiatric disorders, childhood and adult trauma, and personality traits. Ann Intern Med. 2001;134(9 Pt 2):917-925.
Sharpe M, Mayou R, Walker J. Bodily symptoms: new approaches to classification. J Psychosom Res. 2006;60: 353-356.

Drug Brand Names

Fluoxetine • Prozac

Disclosure

The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

Box

Medically unexplained physical symptoms: A common condition

Medically unexplained physical symptoms (MUPS) has been found to make up 10% to 30% of the physical symptoms in primary care clinics and 37% to 66% in specialty clinics.^a-c The latter statistic is based on a cross-sectional survey of 899 consecutive new patients from 7 outpatient clinics in London, United Kingdom. Sixty-five percent responded and 52% of respondents had at least 1 medically unexplained symptom, diagnosed 3 months after initial clinic presentation.^c

Patients with MUPS carry significant clinical importance. They are more likely to have a relatively poor quality of life and higher rates of disability.^d,e They tend to be higher utilizers of health care.^c,f High utilization of services and potentially unnecessary lab testing and consultation result in increased costs and high rates of iatrogenic complications.^d-f

References

a. McCarron RM, Xiong GL, Bourgeois JA. Lippincott’s primary care psychiatry. Philadelphia, PA: Lippincott Williams and Wilkins; 2009.
b. Richardson RD, Engel CC. Evaluation and management of medically unexplained physical symptoms. Neurologist. 2004;10:18-30.
c. Nimnuan C, Hotopf M, Wessely S. Medically unexplained symptoms. An epidemiological study in seven specialties. J Psychosom Res. 2001;51:361-367.
d. Reid S, Wessely S, Crayford T, et al. Medically unexplained symptoms in frequent attenders of secondary health care: retrospective cohort study. BMJ. 2001;322:1-4.
e. Smith BJ, McGorn KJ, Weller D, et al. The identification in primary care of patients who have been repeatedly referred to hospital for medically unexplained symptoms: a pilot study. J Psychosom Res. 2009;67:207-211.
f. Smith RC, Lein C, Collins C, et al. Treating patients with medically unexplained symptoms in primary care. J Gen Intern Med. 2003;18:478-489.