The Need for Improved Access to Mental Health Services for Youth With Medically Unexplained Symptoms

2018 ◽  
Vol 18 (5) ◽  
pp. 29-31 ◽  
Author(s):  
Kristin Canavera ◽  
Jennifer Allen ◽  
Liza-Marie Johnson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Medically Unexplained Symptoms ◽  
Medically Unexplained ◽  
Unexplained Symptoms

scholarly journals Preventing somatization

2004 ◽  
Vol 34 (2) ◽  
pp. 195-198 ◽  
Author(s):  
MATTHEW HOTOPF
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Psychiatric Disorder ◽  
Secondary Care ◽  
Medically Unexplained Symptoms ◽  
Cross Sectional ◽  
Frequent Attenders ◽  
Medically Unexplained ◽  
Significant Disability ◽  
Unexplained Symptoms

Countless cross-sectional surveys of primary and secondary care have demonstrated the ubiquitous nature of medically unexplained symptoms. If grouping diverse symptoms under one heading is appropriate, they account for over half of all new presentations in secondary medical care (Nimnuan et al. 2001a) and a sizeable proportion of ‘frequent attenders’ in secondary care have predominantly medically unexplained symptoms (Fink, 1992a; Reid et al. 2002). Such symptoms are costly, persistent, and associated with significant disability and psychiatric disorder (Reid et al. 2001, 2003), but are generally ignored by mental health services (Bass et al. 2001).

scholarly journals Medically unexplained symptoms in primary care

2008 ◽  
Vol 14 (6) ◽  
pp. 432-440 ◽  
Author(s):  
Else Guthrie
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Physical Abuse ◽  
Medically Unexplained Symptoms ◽  
Psychological Needs ◽  
Stepped Care ◽  
Childhood Neglect ◽  
Medically Unexplained ◽  
Primary Care Patients ◽  
Unexplained Symptoms

Adult patients with medically unexplained symptoms (somatisation) in primary care are numerous and make disproportionately high demands on health services. Most of these individuals are open to the suggestion that their illness reflects psychological needs. Empowering explanations from doctors can enable patient and doctor to work collaboratively in managing the problem and can reduce healthcare contacts. Parental medically unexplained symptoms, sexual and physical abuse in childhood and childhood neglect are associated with a greater risk of medically unexplained symptoms in adulthood. The overall prognosis for the majority of primary care patients with medically unexplained symptoms is very good. The two most common approaches to dealing with medically unexplained symptoms in primary care are stepped-care approaches and teaching general practitioners new skills to manage consultations more effectively.

Ethical Psychotherapeutic Management of Patients with Medically Unexplained Symptoms: The Risk of Misdiagnosis and Harm

2020 ◽  
Author(s):  
Diane O'Leary ◽  
Keith Geraghty
Keyword(s):  
Mental Health ◽  
Health Management ◽  
Medically Unexplained Symptoms ◽  
Chronic Fatigue ◽  
Medical Settings ◽  
Diagnostic Uncertainty ◽  
Fatigue Syndrome ◽  
Psychological Diagnosis ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Management of medically unexplained symptoms (MUS) is undergoing a period of change. We see this in the recent breakdown of consensus on mental health management of quintessential medically unexplained conditions (like myalgic encephalomyelitis/chronic fatigue syndrome), and in recent work in bioethics suggesting that the issue of biological versus mental health management of MUS is fundamentally an ethical matter. For these reasons, it is important to think carefully about ethical aspects of MUS management in psychotherapeutic settings. In the first part of this chapter, the authors show how ambiguity in the term “MUS” leads to routine conflation of diagnostic uncertainty with psychological diagnosis for unexplained symptoms in medical settings. The second part of the chapter explores evidence suggesting that substantial harm results from a failure to draw that distinction in medical settings, and clarifies the psychotherapist’s obligations to avoid those harms. The authors then explore the risk for psychological harms when psychotherapists conflate diagnostic uncertainty with psychological diagnosis. Finally, they consider challenges to informed consent in psychotherapy for MUS. The chapter concludes with principles for ethical psychotherapeutic management of MUS.

An exploratory study of primary-care therapists' perceived competence in providing cognitive behavioural therapy to people with medically unexplained symptoms

2013 ◽  
Vol 6 ◽  
Author(s):  
Hilary Lewis
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Problems ◽  
Medically Unexplained Symptoms ◽  
Perceived Competence ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Common Mental Health Problems ◽  
Medically Unexplained ◽  
Unexplained Symptoms

AbstractThe scope of the Improving Access to Psychological Therapies (IAPT) initiative has been extended to include the treatment of medically unexplained symptoms (MUS). However, MUS was not one of the original common mental health problems that the therapists were trained to treat. No studies have explored whether primary-care cognitive behavioural therapists feel competent to treat people with MUS. This paper aimed to explore and gain an understanding of primary-care therapists’ perceived competence in providing cognitive behavioural therapy (CBT) to people with MUS. Eight CBT therapists working in primary care participated in semi-structured interviews; the Framework approach was used to analyse the data. Five themes were generated by the data analysis, regarding the therapists’ perceived competence. The therapists described unfamiliarity with MUS. They also described some issues in engaging clients in therapy and that progress in therapy could sometimes be slow. Participants often used more general CBT skills and techniques, rather than models and interventions designed specifically for MUS. They had a number of different emotional reactions to this work. CBT therapists in primary care described unfamiliarity with MUS, in comparison to common mental health problems. They identified some difficulties in treatment, but most did not see this group as being more complex to treat. All were interested in receiving training about this client group.

scholarly journals A systematic review of randomised controlled trials using psychological interventions for children and adolescents with medically unexplained symptoms: A focus on mental health outcomes

2019 ◽  
Vol 25 (1) ◽  
pp. 273-290 ◽  
Author(s):  
Christine O’Connell ◽  
Roz Shafran ◽  
Sophie Bennett
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Children And Adolescents ◽  
Medically Unexplained Symptoms ◽  
Mental Health Outcomes ◽  
Psychological Interventions ◽  
Medically Unexplained ◽  
Mental Health Difficulties ◽  
Unexplained Symptoms ◽  
Randomised Controlled

Background: Medically unexplained symptoms affect between 4% and 20% of children and adolescents; 30–60% of these children also experience mental health difficulties. Trials and reviews have focussed on physical gains in this population, often overlooking mental health outcomes. Objectives: To use a systematic review methodology guided by the PRISMA checklist to (1) investigate the effectiveness of psychological interventions for mental health difficulties in children and adolescents with medically unexplained symptoms and (2) identify aspects of interventions associated with their success. Methods: Randomised controlled studies investigating the impact of psychological interventions on mental health in children and adolescents with medically unexplained symptoms were included. Systematic searches of PsycINFO, MEDLINE and CINAHL were undertaken from inception to January 2018. Studies were appraised using the quality appraisal checklist. A qualitative synthesis of studies was completed. Results: In all, 18 studies were identified. Interventions targeting parental responses to illness and family communication appeared to have the best outcomes. Conclusions: Psychological interventions may be effective in improving mental health outcomes within this population; however, evidence for the efficacy of these interventions is limited due to a high risk of bias within the majority of reviewed studies. Future research using rigorous methodology and non–cognitive behavioural therapy interventions is recommended.

Travelling at a hundred miles an hour and not being able to get off: Examining a patient’s journey from medically unexplained symptoms

2018 ◽  
Vol 6 (3) ◽  
pp. 400
Author(s):  
Kelvin Leung ◽  
Foluke Odeyale ◽  
Itoro Udo
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Medically Unexplained Symptoms ◽  
Severity Of Illness ◽  
Physical Symptoms ◽  
Mental Wellbeing ◽  
Liaison Psychiatry ◽  
Patient’S Experience ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Objectives: To understand a patient’s experience of treatment and recovery from medically unexplained tremors affecting hand and neck. The patient attended a Liaison Psychiatry Outpatient Clinic.Method: A case study using interview method focusing on the nature and severity of illness; effects of symptoms; expectations of treatment; changes observed and the patient’s expectation of services.Results: The patient was “extremely” stressed about his symptoms and “apprehensive” about attending mental health services. He experienced resolution of physical symptoms and improvements in mental wellbeing. Mental health treatment comprised medications and psychological therapies.Conclusions: Persons experiencing medically unexplained symptoms deserve positive experiences of well-funded specialist healthcare.

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