[Unexplained phsyical complaints amongst prison inmates: diagnois and treatment]

Daily physiological processes, excess physical fatigue, subclinical viral infections and certain environmental situations can all cause some kind of physical pain or malaise in 75% of adults in a typical week. When the individual refuses to accept medical opinion and attributes the pain to a physical illness and persistently seeks diagnosis and treatment, then there is a possibility of an unexplained somatic problem. Depression, anxiety or even a personality disorder may be causative factors. The lack of studies of this type of disorder in the prison environment makes it difficult to fully evaluate the importance of this phenomenon for primary health care consultation in prison, despite the fact that the number of presented unexplained somatic complaints may well be the same as in the community (around 15%). Management of this type of patient is always difficult, complex and emotionally demanding for the health care professional.