Medically unexplained symptoms in frequent attenders of secondary health care: retrospective cohort study.
OBJECTIVE
To estimate the prevalence of medically unexplained symptoms in patients who most frequently attend outpatient services.


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


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


METHODS
Outpatient attenders with new appointments in 1993.


METHODS
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.
Academic Department of Psychological Medicine, Guy's, King's College, and St Thomas's Hospital School of Medicine and Institute of Psychiatry, London SE5 8AZ, UK. steve.reid@kcl.ac.uk
S
S
Reid
S
S
Wessely
T
T
Crayford
M
M
Hotopf
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology; D002637:Chest Pain / Q000209:etiology; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013001:Somatoform Disorders / Q000628:therapy*