trishrhymes
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Can anyone access the full article. The abstract looks bad. Classifies ME as psychological.
How should we manage adults with persistent unexplained physical symptoms?
Persistent physical symptoms are common and include those symptoms that last at least three months and are insufficiently explained by a medical condition after adequate examination and investigation.12 Examples include unexplained abdominal pain, musculoskeletal pains, fatigue, headache and dizziness. These symptoms are often associated with functional impairment and psychological distress among patients, and increase healthcare costs.2345 Observational studies in primary care report that women, especially those aged 35-45 years, more commonly present with these symptoms.25
Defining and categorising an unexplained symptom is tricky and disputed (see box 1).910 Sometimes symptoms fit criteria for somatoform or psychiatric disorders set out in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV)6 or functional somatic syndromes such as irritable bowel syndrome. In other cases there is no label to offer the patient.
Box 1: Terminology used in this article
How should we manage adults with persistent unexplained physical symptoms?
Persistent physical symptoms are common and include those symptoms that last at least three months and are insufficiently explained by a medical condition after adequate examination and investigation.12 Examples include unexplained abdominal pain, musculoskeletal pains, fatigue, headache and dizziness. These symptoms are often associated with functional impairment and psychological distress among patients, and increase healthcare costs.2345 Observational studies in primary care report that women, especially those aged 35-45 years, more commonly present with these symptoms.25
Defining and categorising an unexplained symptom is tricky and disputed (see box 1).910 Sometimes symptoms fit criteria for somatoform or psychiatric disorders set out in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV)6 or functional somatic syndromes such as irritable bowel syndrome. In other cases there is no label to offer the patient.
Box 1: Terminology used in this article
- Persistent unexplained physical symptoms—Physical symptoms existing for ≥3 months not sufficiently explained by an underlying medical condition after adequate examination and investigation2
- Somatoform disorders—Psychiatric disorders (DSM-IV, ICD-10) with persistent unexplained physical symptoms as key factor6
- Undifferentiated somatoform disorder—One or more physical symptoms without medical explanation with clinically significant suffering or functional impairment, existing for ≥6 months6
- Functional somatic syndrome—A combination of unexplained physical symptoms occurring together (such as irritable bowel syndrome or chronic fatigue syndrome)7
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