ABC of Medically Unexplained Symptoms

This brand new title addresses the complex issues faced by primary health care practitioners in treating and managing patients with ‘medically unexplained symptoms'. It aims to develop guidelines and principles to help identify patients with medically unexplained symptoms, as they are typically underdiagnosed, and to manage symptoms more effectively with active patient involvement.

Contributors vii

Acknowledgements ix

1 Introduction 1
Chris Burton

2 Epidemiology and Impact in Primary and Secondary Care 5
Alexandra Rolfe and Chris Burton

3 Considering Organic Disease 7
David Weller and Chris Burton

4 Considering Depression and Anxiety 10
Alan Carson and Jon Stone

5 Medically Unexplained Symptoms and the General Practitioner 15
Christopher Dowrick

6 Principles of Assessment and Treatment 18
Chris Burton

7 Palpitations Chest Pain and Breathlessness 22
Chris Burton

8 Headache 27
David P. Kernick

9 Gastrointestinal Symptoms: Functional Dyspepsia and Irritable Bowel Syndrome 31
Henriëtte E. van der Horst

10 Pelvic and Reproductive System Symptoms 36
Nur Amalina Che Bakri, Camille Busby-Earle, Robby Steel and Andrew W. Horne

11 Widespread Musculoskeletal Pain 40
Barbara Nicholl, John McBeth and Christian Mallen

12 Fatigue 43
Alison J. Wearden

13 Neurological Symptoms: Weakness Blackouts and Dizziness 47
Jon Stone and Alan Carson

14 Managing Medically Unexplained Symptoms in the Consultation 52
Avril F. Danczak

15 Cognitive Approaches to Treatment 56
Vincent Deary

16 Behavioural Approaches to Treatment 60
Vincent Deary

17 Pharmacological Treatment 64
Killian A. Welch

18 Conclusion 68
Chris Burton

Appendix: Suggestions for Reflection and Audit 69
Chris Burton

Index 71

“The major contribution this monograph makes is to recognize that not all symptoms are readily explainable by a clear diagnosis. To young clinicians, this can be especially important as they face both the straightforward diagnosis and the conundrum. It is an easy read and another tool for working with primary care patients. ” (Doody’s, 30 August 2013)

About the ABC series

The new ABC series has been thoroughly updated, offering a fresh look, layout and features throughout, helping you to access information and deliver the best patient care. The newly designed books remain an essential reference tool for GPs, GP registrars, junior doctors and those in primary care, designed to address the concerns of general practitioners and provide effective study aids for doctors in training.

Now offering over 70 titles, this extensive series provides you with a quick and dependable reference on a range of topics in all the major specialities. Each book in the new series now offers links to further information and articles, and a new dedicated website provides you with even more support.

The ABC series is the essential and dependable source of up-to-date information for all practitioners and students in general practice.

To receive automatic updates on books and journals in your specialty, join our email list. Sign up today at www.wiley.com/email

ABC of Medically Unexplained Symptoms

About the ABC of Medically Unexplained Symptoms

Christopher Burton, Senior Lecturer in Primary Care, University of Aberdeen, UK

ABC of Medically Unexplained Symptoms is a clear and practical guide to the identification and management of patients with symptoms not adequately explained by disease. It provides an overview of general principles and techniques and discusses in detail specic common symptoms such as headache, pain, breathlessness, fatigue and dizziness. It covers vital information on the assessment of symptoms, provides constructive explanations, and describes cognitive, behavioural and pharmacological approaches to treatment. Recognising the particular challenges that medically unexplained symptoms represent, it explains how to communicate with patients and involve them in managing their own symptoms.

Written by an expert author team, ABC of Medically Unexplained Symptoms is ideal for general practitioners, practice nurses and specialist nurses, medical students and others working within primary care settings.