WHAT ARE MEDICALLY UNEXPLAINED SYMPTOMS?
Bodily symptoms are common in community samples, but not all people consult for medical advice about such symptoms. Medically unexplained symptoms (MUS) refer to persistent bodily complaints for which adequate examination (including investigation) does not reveal sufficiently explanatory structural or other specified pathology.1 MUS are common, with a spectrum of severity, and patients are found everywhere within the healthcare system.2 It has been estimated that MUS account for up to 45% of all general practice consultations,3 while a study based in secondary care indicated that about 50% of patients had no clear diagnosis at 3 months.2
WHAT ARE THE COSTS OF MUS?
The annual NHS cost for MUS in adults of working age in England was estimated to be £2.89 billion in 2008/2009 (11% of total NHS spend), while sickness absence and decreased quality of life for people with MUS was estimated as costing over £14 billion per annum to the UK economy.4
Although the costs to the NHS and the economy are important considerations, the personal cost to the patient can also be significant. Patients often experience stress, distress, and anxiety because of their unexplained symptoms. They report feeling that their concerns are not taken seriously by their doctor, which can exacerbate the presentation of somatic symptoms. The suggestion that ‘negative test results means that nothing is wrong’ is cited as the most common explanation given by doctors,5 but patients can feel that their symptoms are not believed, and may disengage from health care (including for other comorbid problems). The anxiety associated with symptoms …