from
http://www.jcpmh.info/resource/guid...rvices-people-medically-unexplained-symptoms/
This document is intended to give guidance to clinical commissioners. In it they state that:
“On average, 52% of patients accessing outpatient services have MUS, with the
highest rates relating to gynaecology clinics (66%) and the lowest rate (37%) relating to dental services 16. Table 2 outlines the proportion of people presenting with MUS across different outpatient clinics.”
This is the table that they show:
Table 2. Proportion of people with MUS in outpatient clinics
Outpatient clinic
Proportion of people with MUS
Gynaecology
66%
Neurology
62%
Gastroenterology
58%
Cardiology
53%
Rheumatology
45%
Respiratory
41%
Dental
37%
Total *
52%
(of which 42% are men, 57% are women)
* From a study of 550 patients
Unsurprisingly they got this % outpatient data from the following 2001 paper (reference number 16)
https://www.researchgate.net/public...an_epidemiological_study_in_seven_specialties
Medically unexplained symptoms An epidemiological study in seven specialities
Authors - Chaichana Nimnuan,
Matthew Hotopf, Simon Wessely
Looking at this study - Under
Case definition
“For this study, medically unexplained symptoms were defined as any current principal somatic complaint reported by patients for which no definite medical diagnosis could be found by physical examination and appropriate investigation.
To make this judgement, we used investigation results and physicians' opinions. The physician's opinion was determined by the final diagnosis stated in the clinical case notes.”
So
they decided whether patients had MUS, not the actual physicians.
Also importantly in the same paper it says in the
Comment section -
“This study has limitations. Firstly,
the required sample size was not obtained due to the low response rate." And "Secondly, although we considered using the diagnosis stated in case notes 3 months after the initial visit as an improvement in defining medically unexplained symptoms,
the final diagnosis is still subject to change afterwards. This may cause over diagnoses of medically unexplained symptoms which later may be reversed."
Hardly a study to base national policy and financing of services on! Also note that gynaecology is top of their list and they say that 57% of the total are women (amusingly 1% are neither men or women!) There is however other published data where gynaecology is
not top of the list, no subtle gender discrimination going on there then! –
Prevalence of MUS in acute out patients in a London Teaching Hospital Clinic %
•Gastroenterology 60%
•Chest 59%
•Rheumatology 58%
•Gynaecology 57%
•Cardiology 56%
•Neurology 55%
•Dental 49%
Information taken from online document - “Complex patients” by Dr Alan Cohen FRCGP, “SAINSBURY CENTRE for MENTAL HEALTH, removing barriers, achieving change”
There is no consistent % rate for women with MUS – it presumably varies so much according to how much women are being discriminated against in different settings! (Anything from 57% women up to 79% women, or “3 or 4 times as many women as men”, depending on which NHS MUS documents you read).