Medically unexplained symptoms need more attention

March 29, 2001

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

Editorial: Medically unexplained symptoms in secondary care

More attention should be given to patients who attend hospital with symptoms that remain medically unexplained after extensive investigation, finds a study in this week's BMJ.

Reid and colleagues reviewed the medical records of 361 patients who most frequently attended outpatient services in one region of England during 1993-6. Of 971 consultations recorded during this period, over a fifth remained medically unexplained. Symptoms that were particularly likely to remain unexplained in this group included abdominal pain, chest pain, headache, and back pain.

Given that frequent attenders in all medical settings are responsible for a disproportionate amount of healthcare resources, these patients should be considered a focus for attention, conclude the authors.

"The fact that a patient returns many times despite being told there is no medical explanation for his or her symptoms reflects continuing distress and concern," writes Jane Turner, Senior Lecturer in Psychiatry, in an accompanying editorial. "Faced with such behaviour, health professionals must consider the possibility of depression, anxiety or somatisation," she suggests.

[Paper]: Steven Reid, Clinical Research Fellow, St Mary's Hospital, London, UK Email:

[Editorial]: Jane Turner, Senior Lecturer in Psychiatry, University of Queensland, Australia Email:


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