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ABC of Medically Unexplained Symptoms

ISBN: 978-1-119-96725-5
88 pages
January 2013, BMJ Books
ABC of Medically Unexplained Symptoms (1119967252) cover image


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.
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Table of Contents

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
Henriette 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

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Author Information

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

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“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)


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