Medically unexplained symptoms - An epidemiological study in seven specialities

Objectives: This study aimed to estimate the prevalence and risk factors fo r medically unexplained symptoms across a variety of specialities. Methods: A cross-sectional survey was conducted at two general hospitals in southea st London between 1995 and 1997. Eight hundred and ninety consecutive new p atients from seven outpatient clinics were included. Demographic and clinic al characteristic variables were assessed. Results: Five hundred eighty-two (65%) of the subjects surveyed returned completed questionnaires. A final diagnosis was available in 550 (62%). Two hundred twenty-eight (52%) fulfil led criteria for medically unexplained symptoms. The highest prevalence was in the gynaecology clinic (66%). After adjustment for confounders. medical ly unexplained symptoms were associated with being female, younger, and cur rently employed. Psychiatric morbidity per se was not associated with the p resence of medically unexplained symptoms, but was more likely in those com plaining of multiple symptoms. Those with medically unexplained symptoms we re less disabled, but more likely to use alternative treatment in compariso n with those whose symptoms were medically explained. Patients with medical ly unexplained symptoms were more likely to attribute their illness to phys ical causes as opposed to lifestyle factors. Conclusions: Medically unexpla ined symptoms are common across general/internal medicine and represent the most common diagnosis in some specialities. Medical behavior, training, an d management need to take this into account. (C) 2001 Elsevier Science Inc. All rights reserved.