Global InformationMedically unexplained physical symptoms information
Medically unexplained physical symptoms (MUPS or MUS) are symptoms for which a treating physician or other healthcare providers have found no medical cause, or whose cause remains contested.[1] In its strictest sense, the term simply means that the cause for the symptoms is unknown or disputed—there is no scientific consensus. Not all medically unexplained symptoms are influenced by identifiable psychological factors.[2] However, in practice, most physicians and authors who use the term consider that the symptoms most likely arise from psychological causes. Typically, the possibility that MUPS are caused by prescription drugs or other drugs is ignored.[3] It is estimated that between 15% and 30% of all primary care consultations are for medically unexplained symptoms.[4] A large Canadian community survey revealed that the most common medically unexplained symptoms are musculoskeletal pain, ear, nose, and throat symptoms, abdominal pain and gastrointestinal symptoms, fatigue, and dizziness.[4] The term MUPS can also be used to refer to syndromes whose etiology remains contested, including chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity and Gulf War illness.[5]
The term medically unexplained symptoms is in some cases treated as synonymous to older terms such as psychosomatic symptoms, conversion disorders, somatic symptoms, somatisations or somatoform disorders; as well as contemporary terms such as functional disorders, bodily distress, and persistent physical symptoms.[6] The plethora of terms reflects imprecision and uncertainty in their definition, controversy, and care taken to avoid stigmatising affected people.[7] Risk factors for medically unexplained symptoms are complex and include both psychological and organic features, and such symptoms are often accompanied by other somatic symptoms attributable to organic disease.[8] As such it is recognised that the boundary defining symptoms as medically unexplained is increasingly becoming blurred.[8]
Women are significantly more likely than men to be diagnosed with Medically Unexplained Symptoms.[9][10] Childhood adversity and/or abuse, and the death or serious illness of a close family member are significant risk factors.[10]
Many patients presenting with medically unexplained symptoms also meet the diagnostic criteria for anxiety and/or depression.[11] The likelihood of meeting such criteria increases with the number of unexplained symptoms reported.[12][13] However, anxiety and depression are also very common in individuals with medically explained illnesses, and again, the likelihood of a person receiving one of these diagnoses increases with the number of symptoms reported.[14][15]
Physical symptoms have been associated with adverse psychosocial and functional outcome across different cultures, irrespective of etiology (either explained or unexplained).[16]
- ^ "Medically unexplained symptoms - NHS Choices". www.nhs.uk. Retrieved 2015-07-18.
- ^ Brown, RJ. 2004. Psychological Mechanisms of Medically Unexplained Symptoms: An Integrative Conceptual Model. Psychological Bulletin 2004 Sep;130(5):793-812
- ^ "Re: Reframing persistent unexplained physical symptoms?". The BMJ: j268. 13 April 2018 – via www.bmj.com.
- ^ a b Kirmayer, LJ; Groleau, D; Looper, KJ; Dao, MD (October 2004). "Explaining medically unexplained symptoms". Canadian Journal of Psychiatry. 49 (10): 663–72. doi:10.1177/070674370404901003. PMID 15560312.
- ^ Richardson RD, Engel CC Jr (Jan 2004). "Evaluation and management of medically unexplained physical symptoms". Neurologist. 10 (1): 18–30. doi:10.1097/01.nrl.0000106921.76055.24. PMID 14720312. S2CID 147872.
- ^ Teodoro T, Oliveira R (November 2022). "The conceptual field of medically unexplained symptoms and persistent somatic symptoms". CNS Spectrums. 28 (5): 526–527. doi:10.1017/S1092852922001031. hdl:10362/147363. PMID 36321347. S2CID 253256995.
- ^ IAPT. (2014). Medically Unexplained Symptoms / Functional Symptoms: Positive Practice Guide. IAPT Medically Unexplained Symptoms Evaluation Task and Finish Group (2012-13)
- ^ a b Creed, F. (2016). Exploding myths about medically unexplained symptoms. Journal of Psychosomatic Research, June 2016, volume 85 pp91-93
- ^ Kozlowska, K. 2013. Stress, Distress, and Bodytalk: Co-constructing Formulations with Patients Who Present with Somatic Symptoms. Harvard Review of Psychiatry. Volume 21 • Number 6 • November/December 2013
- ^ a b JCPFMH. (2017). Guidance for Commissioners of Services for People with Medically Unexplained Symptoms. Joint Commissioning Panel for Mental Health. Royal College of General Practitioners and the Royal College of Psychiatrists
- ^ Li, C. T.; Chou, Y. H.; Yang, K. C.; Yang, C. H.; Lee, Y. C.; Su, T. P. (2009). "Medically Unexplained Symptoms and Somatoform Disorders: Diagnostic Challenges to Psychiatrists". Journal of the Chinese Medical Association. 72 (5): 251–256. doi:10.1016/S1726-4901(09)70065-6. PMID 19467948. S2CID 18329997.
- ^ Kroenke, K. (2003). "Patients presenting with somatic complaints: epidemiology, psychiatric comorbidity and management". International Journal of Methods in Psychiatric Research. 12 (1): 34–43. doi:10.1002/mpr.140. ISSN 1049-8931. PMC 6878426. PMID 12830308.
- ^ Kroenke, K.; Rosmalen, G. (Jul 2006). "Symptoms, syndromes, and the value of psychiatric diagnostics in patients who have functional somatic disorders". The Medical Clinics of North America. 90 (4): 603–626. doi:10.1016/j.mcna.2006.04.003. ISSN 0025-7125. PMID 16843765.
- ^ Kisely, S; Goldberg, D; Simon, G (September 1997). "A comparison between somatic symptoms with and without clear organic cause: results of an international study". Psychological Medicine. 27 (5): 1011–9. doi:10.1017/s0033291797005485. PMID 9300507. S2CID 21597635.
- ^ Kroenke, K; Spitzer, RL; Williams, JB; Linzer, M; Hahn, SR; deGruy FV, 3rd; Brody, D (September 1994). "Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment". Archives of Family Medicine. 3 (9): 774–9. doi:10.1001/archfami.3.9.774. PMID 7987511.
{{cite journal}}: CS1 maint: numeric names: authors list (link) - ^ Kisely S, Simon G (February 2006). "An international study comparing the effect of medically explained and unexplained somatic symptoms on psychosocial outcome". J Psychosom Res. 60 (2): 125–30. doi:10.1016/j.jpsychores.2005.06.064. PMID 16439264.