How should we manage adults with persistent unexplained physical symptoms?

As an emergency medicine Doctor, my interest in Persistent Physical symptoms is unusual. I have a second interest in hypnosis, and am a member of the British Society of Clinical and Academic Hypnosis (BSCAH), and mainly through that, I have learnt a lot about PPS (formally known as MUS).

There are many more resources that could be recommended to patients including two excellent leaflets from RCPsych:
- http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/medicallyunexpla...
- http://www.rcpsych.ac.uk/healthadvice/parentsandyouthinfo/parentscarers/...

For healthcare professionals, I really like
http://www.rcemfoamed.co.uk/portfolio/the-elephant-in-the-room-somatisat...
and would really recommend the Maudsley's MUS course - http://www.maudsleysimulation.com/medically-unexplained-symptoms-assessm.... http://www.rcpsych.ac.uk/pdf/CHECKED%20MUS%20Guidance_A4_4pp_6.pdf has some useful summary points.

As someone has already mentioned, it is useful to say to patients something like "at the moment, we can't identify a cause for your symptoms. That doesn't mean they're not real, but it does mean we now need to focus on how best your symptoms can be managed safely". Part of this, is remembering, that we do miss things. BSCAH started to do a series on diagnoses commonly missed, and attributed to the medically unexplained - starting with Brucellosis and CO poisoning. You can read the summaries: http://www.bscah.com/newsletters