Management Of Medically Unexplained Symptoms

Question 1

What is the preferred term for medically unexplained symptoms?

Answer 1

Persistent Physical Symptoms
(Preferred by most except for FND patients)

Question 2

What is the prevalence of unexplained symptoms in primary care?

Answer 2

20-40% in primary care
Up to 50% if secondary care clinics

Question 3

What is the misdiagnosis rate (diagnosed as MUS but organic disease)?

Answer 3

4% at 5 years
Same as other neurological disorders
MUS is a stable diagnosis

Question 4

How much does the NHS spend on treating MUS?

Answer 4

£3 billion +

10% of NHS budget

Question 5

What are the maintaining (perpetuating) factors of MUS?

Answer 5

Autonomic dysregulatiob (physical)
Avoidance of symptoms/activity (behavioural)
All or nothing behaviour
Attention to symptoms (cognitive)
Views of symptoms (cognitive)
Poor professional management (social)
Loss of role (social)
Unhelpful role of others/ too much help (social)

Question 6

What is the model for treatment of MUS?

Answer 6

Positive explanation of diagnosis

Step-wise approach
Guided self help
CBT
Liaison psychiatry

Question 7

What are the three targets of CBT for MUS?

Answer 7

Behaviour
Cognition
Physical symptoms

Question 8

What are the symptoms for chronic fatigue syndrome?

Answer 8

Widespread muscular pain
Generalised stiffness
Persistent fatigue
Non-refreshing sleep