Medically unexplained symptoms in secondary care

doi:10.1136/bmj.322.7289.745

BMJ 2001;322:745-746 ( 31 March )

Editorials

Medically unexplained symptoms in secondary care

Consider the possibility of anxiety or depression $---$ or simply distress

Papers p 767

The first 150 words of the full text of this article appear below.

The efficient use of medical resources is important, so the findings of Reid et al in this issue (p 767)¹ are timely, highlightingthe previously undocumented number of frequent attenders at secondarycare consultations with medically unexplained symptoms. However,this study raises concerns other than economic ones: there appearto be large numbers of patients whose frequent attendance suggestsdistress that is neither appropriately identified oraddressed.

The reasons for frequent attendance by such patients are undoubtedly complex. At least for the first consultation, attendancemay reflect the referral patterns of general practitioners. Medicallyunexplained symptoms are very common in primary care,² butprimary care physicians seem to have considerable discomfort inmanaging these patients.³ Any patient whose symptoms cannotbe explained raises the concern, "What am I missing?" Compoundingthis unease is the expectation or demand of the patient for aspecialist opinion, against a background of increasing. . . [Full text of this article]

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Rapid Responses:

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