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Medically unexplained symptoms--a perspective from general practitioners in the developing world.

Muhammad Ishrat Husain1, Venugopal Duddu, Muhammad Omair Husain

  • 1Department of Psychiatry, South West London and St George's NHS Trust, Springfield University Hospital, London, UK. ishrat-h@doctors.net.uk

International Journal of Psychiatry in Medicine
|March 1, 2012
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Summary
This summary is machine-generated.

Pakistani general practitioners (GPs) largely share Western attitudes toward medically unexplained symptoms (MUS), emphasizing support and reassurance. However, they focus more on physical causes than psychiatric diagnoses for MUS.

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Area of Science:

  • Psychiatry
  • General Practice
  • Medical Sociology

Background:

  • Medically Unexplained Symptoms (MUS) pose diagnostic and management challenges in primary care globally.
  • Understanding general practitioners' (GPs) attitudes is crucial for effective patient care and healthcare system design.

Purpose of the Study:

  • To explore the attitudes of 500 general practitioners (GPs) in Karachi, Pakistan, towards Medically Unexplained Symptoms (MUS).
  • To compare Pakistani GPs' attitudes with those reported by GPs in developed countries.

Main Methods:

  • A questionnaire, previously validated by Reid et al. (2001), was administered to 500 GPs in Karachi.
  • Data collection involved a postal survey with a follow-up telephone reminder to non-respondents.
  • A total of 429 GPs completed the survey.

Main Results:

  • A high percentage of Pakistani GPs (80.2%) believe their primary role is to offer support and reassurance to patients with MUS.
  • A significant majority (76.9%) also see a role in referring patients for further investigations to identify potential physical causes.
  • While 47.55% found the concept of somatization useful, only 34.03% felt effective treatments were available.

Conclusions:

  • Pakistani GPs' attitudes towards MUS are broadly similar to their Western counterparts, particularly regarding the importance of reassurance.
  • A key difference lies in Pakistani GPs' tendency to prioritize the search for underlying physical causes over psychiatric diagnoses for MUS.
  • This highlights a potential area for targeted educational interventions to improve the management of MUS in Pakistan.