title: Outbreaks of medically unexplained physical symptoms after military action, terrorist threat, or technological disaster.
abstract: Medically unexplained physical symptoms (MUPS) may present a challenge to clinicians, disaster response organizations, and scientists after future military actions, terrorist threats, or technological disasters. Polarized public discussion over science, policy, and media evidence following such incidents may reinforce the notion of cover-ups, create mutual doctor-patient mistrust, amplify symptom-related psychosocial distress and disability, and lead to unnecessary use of services. Under these circumstances, the clinician must always show respect, empathy, and validation for a patient's concerns. A skeptical attitude may induce efforts by patients to "prove" their symptoms are "real." If MUPS are discounted as a "non-problem," they may become a much bigger public health problem when patients feel their symptoms and concerns have been discounted by unfeeling government clinicians, and patient "horror stories" become grist for media and political mills.
authors.affiliation: Department of Psychiatry, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. cengel@pobox.com
authors.forename: C C
authors.initials: CC
authors.lastname: Engel
mesh_terms: D004196:Disease Outbreaks; D006801:Humans; D010817:Physician-Patient Relations; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy