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Medically unexplained symptoms: assessment and management.

Mujtaba Husain1, Trudie Chalder2

  • 1South London and Maudsley NHS Foundation Trust (SLaM), London, UK mujtaba.husain@slam.nhs.uk.

Clinical Medicine (London, England)
|January 22, 2021
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Summary

Medically unexplained symptoms (MUS) are real, causing distress and high costs. This paper offers a practical approach to diagnosing and managing persistent physical symptoms effectively.

Keywords:
cognitive behavioural therapymedically unexplained symptomspersistent physical symptoms

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Area of Science:

  • Medicine
  • Psychiatry
  • General Practice

Background:

  • Medically unexplained symptoms (MUS) are prevalent and represent a significant challenge in healthcare.
  • These symptoms are associated with considerable patient distress, functional impairment, and elevated healthcare expenditures.
  • Accurate diagnosis and effective management are crucial for improving patient outcomes and reducing healthcare burden.

Purpose of the Study:

  • To outline a practical framework for the assessment and management of patients presenting with persistent physical symptoms.
  • To provide clinicians with a stepwise approach to diagnosing and treating medically unexplained symptoms.
  • To emphasize the importance of understanding the impact of symptoms on patients' lives to guide treatment strategies.

Main Methods:

  • A comprehensive review of diagnostic and management principles for medically unexplained symptoms.
  • Emphasis on the integration of patient history, physical examination, and targeted investigations.
  • Discussion of strategies for exploring the impact of symptoms and tailoring patient advice.

Main Results:

  • The diagnostic process for persistent physical symptoms requires a thorough clinical evaluation.
  • Understanding the patient's experience and the impact of symptoms is key to effective management.
  • A stepwise approach to management, informed by assessment, can improve outcomes.

Conclusions:

  • Medically unexplained symptoms necessitate a structured diagnostic and management approach.
  • Effective care involves acknowledging the reality of symptoms and addressing their impact.
  • This paper provides a practical guide for clinicians managing patients with persistent physical symptoms.