Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion

Abstract

This study was undertaken to assess recognition of medically unexplained physical symptoms by general practitioners (GPs), and the feasibility of using a screening procedure based on validated self-report questionnaires. GPs identified unexplained physical symptoms as the main clinical problem for 19% of attending patients. Screening instruments identified 35% of patients as having multiple unexplained physical symptoms, of whom 5% were probable cases of somatization disorder. Nine percent of attending patients reported high levels of health anxiety. Twenty percent were probable cases of mood disorder: in half of these, psychological symptoms were not documented in the casenotes. Patients with more somatic symptoms and higher health anxiety were more likely to be recognized by the GP: higher levels of mood symptoms did not predict recognition. The screening procedure used in this study shows promise and merits further investigation.