Doctors and social epidemics : the problem of persistent unexplained physical symptoms, including chronic fatigue.

Among general practitioners (GPs) opinion has been
divided about the validity of chronic fatigue syndrome or
myalgic encephalopathy (CFS/ME) as an illness. Now, in a
report to the Chief Medical Officer (CMO) an expert group
has concluded that the condition is indeed a chronic illness
meriting significant NHS resources, including the unreserved
attention of the medical profession. Widespread
publicity was given to the CMO’s enthusiastic reception of
the report, which included the statement: ‘This is a real disease

Understanding the "worried well".

The burden of giving a diagnosis to patients who have no discernible clinical findings is often frustrating and anxiety provoking for the primary care clinician. This frustration is magnified when that patient returns on a frequent basis. These patients have been called the worried well, but there is no good CPT code for this diagnosis. Smith et al (1) have taken a novel approach to evaluating patients who are frequent users of primary care services.

Peritraumatic dissociation and physiological response to trauma-relevant stimuli in Vietnam combat veterans with posttraumatic stress disorder


A recent study found that female rape victims with acute posttraumatic stress disorder (PTSD) who received a high score on the Peritraumatic Dissociative Experiences Questionnaire exhibited suppression of physiological responses during exposure to trauma-related stimuli. The goal of our present study was to test whether the same relationship holds true for male Vietnam combat veterans with chronic PTSD, using secondary analyses applied to data derived from a Veteran's Affairs Cooperative Study.

Medically unexplained symptoms and the problem of power in the primary care consultation : a qualitative study.



Patients presenting in primary care frequently exhibit physical symptoms that may be unrelated to organic pathology. Such symptoms are commonly regarded as products of psychological or emotional problems, and their legitimacy as 'medical' matters is often called into question.


Our aim was to explore GPs' attitudes to the management of patients that present with medically unexplained symptoms in primary care.


Impact of Event Scale : psychometric properties.



For more than 20 years, the Impact of Event Scale (IES) has been widely used as a measure of stress reactions after traumatic events.


To review studies that evaluated the IES's psychometric properties.


Literature review.


Evaluation of diagnostic procedures

This is the first of a series of five articles