scholarly journals Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Madelon den Boeft ◽  
Danielle Huisman ◽  
Johannes C. van der Wouden ◽  
Mattijs E. Numans ◽  
Henriette E. van der Horst ◽  
...  
2017 ◽  
Vol 67 (661) ◽  
pp. e572-e579 ◽  
Author(s):  
Aase Aamland ◽  
Anette Fosse ◽  
Eline Ree ◽  
Eirik Abildsnes ◽  
Kirsti Malterud

BackgroundPatients with long-lasting and disabling medically unexplained physical symptoms (MUPS) are common in general practice. GPs have previously described the challenges regarding management and treatment of patients with MUPS.AimTo explore GPs’ experiences of the strategies perceived as helpful when seeing patients with MUPS.Design and settingThree focus group interviews with a purposive sample of 24 experienced GPs were held in southern Norway.MethodDiscussions were audiotaped and transcribed. Systematic text condensation was used for analysis.ResultsSeveral strategies were considered helpful during consultations with patients with MUPS. A comprehensive outline of the patient’s medical past and present could serve as the foundation of the dialogue. Reviewing the patient’s records and sharing relevant information with them or conducting a thorough clinical examination could offer ‘golden moments’ of trust and common understanding. A very concrete exchange of symptoms and diagnosis interpretation sometimes created a space for explanations and action, and confrontations could even strengthen the alliance between the GP and the patient. Bypassing conventional answers and transcending tensions by negotiating innovative explanations could help patients resolve symptoms and establish innovative understanding.ConclusionGPs use tangible, down-to-earth strategies in consultations with patients with MUPS. Important strategies were: thorough investigation of the patient’s symptoms and story; sharing of interpretations; and negotiation of different explanations. Sharing helpful strategies with colleagues in a field in which frustration and dissatisfaction are not uncommon can encourage GPs to develop sustainable responsibility and innovative solutions.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1573-1573
Author(s):  
V. Pais ◽  
D. Correia ◽  
F. Ramalho e Silva

BackgroundMedically unexplained physical symptoms (MUPS) can be defined as physical symptoms that have no currently known physical pathological cause. MUPS account for one in five new consultations in primary care and for one third of new patients when neurology consultations are considered.Patients with MUPS present significant distress and impaired function and their diagnosis is sometimes hard to establish. The classification of somatoform disorders has been found to be insufficiently useful for therapeutic and scientific purposes. Some authors suggest that new classifications should attend to clinical utility, defined as (1) the extent to which a diagnosis can help clinicians understand or conceptualize a disorder in their daily work; (2) the extent to which a diagnosis can help the clinician communicate useful information to others, including practitioners, family members, patients, and administrators; (3) the extent to which the presence of a disorder helps the clinician choose effective interventions, and (4) the extent to which a disorder can predict future clinical management needs.AimThis review aims to discuss the management of MUPS in mental health services, attending to the importance of a multidisciplinary approach.MethodsPubmed Medline search on MUPS and review of recent literature.DiscussionThe management of MUPS implies a multidisciplinary approach that can offer different solutions for different degrees of disorder severity and takes into account the perception of the patient about his own illness. New classifications of somatoform disorders that include comprehensible explanations about these symptoms could be helpful for patients and health professionals.


2017 ◽  
Vol 23 (6) ◽  
pp. 428-430
Author(s):  
David S. Baldwin

SummaryIn his early novels, the Icelandic Nobel laureate Halldór Laxness portrayed troubled individuals beset by familial, societal and economic challenges within an unpredictable and often unforgiving landscape; his later work addressed humanistic concerns regarding a well-lived life and the harmony of individual and environment. His 1957 novel The Fish Can Sing lies at the cusp of these preoccupations. Laxness contrasts the economic privations experienced by hard-pressed Icelanders with the ostentatious displays of their Danish colonial overloads; he also portrays individuals afflicted by psychosis, alcohol use disorders and medically unexplained physical symptoms, and delineates the path towards a ‘celebrity’ suicide. The novel warns against self-deceptive vanity and community-endorsed illusions, and celebrates the persistent benefits of nurturing relationships, all within a lyric contemplation of individual adaptive resilience and quotidian domestic pleasures.


Sign in / Sign up

Export Citation Format

Share Document