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Medically unexplained conditions considered by patients in general practice.

Hedda Tschudi-Madsen1, Mona Kjeldsberg, Bård Natvig

  • 1Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, PO Box 1130, Blindern, N-0318 Oslo and.

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Summary

Many patients worry they have unexplained conditions (UCs), especially with high symptom load and life stressors. The number of symptoms can indicate concerns about multisymptom conditions.

Keywords:
Causal attributiongeneral practicemedically unexplained symptomsmultisymptomatologysymptom reporting.

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Area of Science:

  • General Practice
  • Symptom Reporting
  • Psychosomatic Medicine

Background:

  • Patients often present with multiple, complex, and 'unexplained' symptoms, posing challenges for healthcare professionals, particularly General Practitioners (GPs).
  • Understanding the patient perspective on these symptoms is crucial for effective healthcare delivery.

Purpose of the Study:

  • To investigate whether patients believe they suffer from conditions commonly classified as unexplained.
  • To explore the relationship between patient concerns about unexplained conditions and their symptom load, life stressors, and socio-demographic factors.

Main Methods:

  • A study involving consecutive, unselected general practice patients who completed questionnaires.
  • The questionnaires addressed eight commonly considered unexplained conditions, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.
  • Logistic regression analysis was used to examine associations with symptom load, life stressors, and socio-demographic variables.

Main Results:

  • Out of 909 respondents, 39.6% considered they might have one or more unexplained conditions (UCs).
  • Concerns about UCs were strongly associated with a higher recent symptom load and an increased number of life stressors.
  • These associations remained significant even when excluding burnout syndrome and food intolerance.

Conclusions:

  • A significant proportion of patients consider their symptoms indicative of unexplained conditions (UCs).
  • The likelihood of patients holding such concerns increases substantially with a higher symptom burden and greater exposure to impactful life stressors.
  • The number of reported symptoms may serve as a key indicator for identifying patients concerned about potentially controversial multisymptom conditions.