Medically unexplained symptoms in frequent attenders of secondary health care: retrospective cohort study.

Abstract

OBJECTIVE:

To estimate the prevalence of medically unexplained symptoms in patients who most frequently attend outpatient services.

DESIGN:

Retrospective cohort study over three years with review of case notes.

SETTING:

Secondary care services in the South Thames (West) NHS region.

PARTICIPANTS:

Outpatient attenders with new appointments in 1993.

MAIN OUTCOME MEASURES:

Number of outpatient appointments, and number of consultation episodes for medically unexplained conditions.

RESULTS:

Medical records of 361 of 400 sampled frequent attenders were examined, and 971 consultation episodes were recorded. Ninety seven (27%) had one or more consultation episodes in which the condition was medically unexplained; 208 (21%) of the 971 consultation episodes were medically unexplained. Abdominal pain, chest pain, headache, and back pain were commonly found to be medically unexplained.

CONCLUSIONS:

Medically unexplained symptoms present in most hospital specialties and account for a considerable proportion of consultations by frequent attenders in secondary care.

Comment in

• Medically unexplained symptoms in secondary care. Unexplained symptoms may reflect overstretched service. [BMJ. 2001]
• Medically unexplained symptoms in secondary care. Doctors in secondary care should respect general practitioners. [BMJ. 2001]

Comment on

• Medically unexplained symptoms in secondary care. [BMJ. 2001]