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Explaining medically unexplained symptoms.

Laurence J Kirmayer1, Danielle Groleau, Karl J Looper

  • 1Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec. laurence.kirmayer@mcgill.ca

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|November 25, 2004
PubMed
Summary

Medically unexplained symptoms are common in primary care. Sociophysiological models offer medical explanations, validating cultural meanings of distress to improve treatment engagement.

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Area of Science:

  • Medical research
  • Psychology
  • Sociology

Background:

  • Medically unexplained symptoms (MUS) account for 15-30% of primary care visits.
  • Current psychological theories inadequately explain common MUS.
  • Physicians often attribute MUS to psychological factors, risking stigma and patient rejection.

Purpose of the Study:

  • To explore alternative medical explanations for MUS.
  • To investigate the role of cultural and social factors in MUS.
  • To propose effective communication strategies for patients with MUS.

Main Methods:

  • Review of psychophysiological and sociophysiological models.
  • Analysis of cross-cultural medical systems and sociosomatic explanations.
  • Examination of patient communication and treatment adherence.

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Main Results:

  • Psychophysiological and sociophysiological models offer plausible medical explanations for common somatic symptoms.
  • Culturally based, sociosomatic explanations are available for most patients.
  • Validating the bodily and cultural meaning of suffering facilitates patient engagement.

Conclusions:

  • Sociophysiological models provide a framework for understanding MUS.
  • Effective communication validating cultural meanings improves treatment acceptance.
  • Behavioral medicine strategies can address psychosocial contributors to chronicity and disability.