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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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