9: Medically Unexplained Symptoms Flashcards
define: medically unexplained symptoms
symptoms for which no medical diagnosis or explanation can be found
define: medically unexplained syndromes
When symptoms occur together regularly in clusters to form a recognizable illness, this may be defined as a “syndrome”
what proportion of the general population experience a medically unexplained symptoms per week
80-90%
What is the MUS rate in GPs and hospitals?
GP= 19-25%
Hospital = 30-70 (average 53%)
define: somatization
the manifestation of psychological difficulty or distress through somatic symptoms
what is the problem with MUS and patient satisfaction?
Patients hate it as they feel that it delegitimizes their symptoms
There is scant evidence that having lots of bodily symptoms is related to denying emotional problems – in fact the opposite is true
More medically unexplained symptoms you have, the more distressed you are, so these symptoms are doing nothing to help with ‘denial’
how does MUS link to anxiety & depression?
More MUS, greater likelihood of anxiety and depression symptoms.
what is the difference between body sensations & body signs?
sensations= immeasurable (eg dizziness, pain)
signs= measurable (eg raised temperature)
how do internal & external cues relate to understanding of body sensations
greater focus on internal sensations leads to a worse interpretation of bodily state (eg running listening to music vs running listening to own breathing - breathing makes you feel more tired)
what are the 3 attributional styles of MUS?
normalising -eg the I am hot cause the room is hot
psychologising - eg I am hot cause I’m stressed
somatising - eg I am hot cause I’m coming down with something
what proportion of patients with MUS have depression or anxiety?
85%
why are patients with mental illness more likely to experience MUS?
because depression & anxiety come with a host of physical symptoms that can be mis-attributed to illness
what is the best approach to treating patients with MUS?
empowering - legitimising the symptoms and explaining why they might come around as a result of psychological misinterpretations while not undermining how distressing they may be
what is the limitation for CBT for MUS?
Problem here is that patients won’t see psychologists - so issue of engagement
what are the stages of reattribution therapy?
Feeling understood - Explore illness belief, respond to emotional cues
Broadening the agenda - Exploration of emotional factors
Making the link - e.g. Stress response, muscle tensions
Collaborating on a treatment or management approach
