title: [The Dutch multidisciplinary guideline entitled 'Medically unexplained physical symptoms and somatoform disorder'].
abstract: The Dutch multidisciplinary guideline called 'Medically unexplained physical symptoms (MUPS) and somatoform disorder' presents a disease-management approach based on three pillars: (a) maintaining patient profiles estimating the risk of iatrogenic harm as well as chronicity, (b) stepped-care treatment starting at a level appropriate for the patient's profile, and (c) the introduction of the family physician as case manager (in serious cases: the medical specialist or psychiatrist) whose task is to channel use of the health care system. Patients with a 'minor risk' profile require psycho-education and two-track treatment by the family physician. The 'moderate risk' profile is complicated by co-morbid depression, anxiety disorder or a somatic disorder; the prognosis is favourable when this co-morbidity is treated. The 'serious risk' profile is assigned to patients with long-term somatoform disorders and a history of surgery for MUPS in addition to disturbed patient-doctor relationships. Limiting iatrogenic harm is of highest priority in these patients. Implementation should focus on providing access to care as described in the guideline.
authors.affiliation: Trimbos Instituut, Utrecht, the Netherlands. cfeltz@trimbos.nl
authors.forename: Christina M
authors.initials: CM
authors.lastname: van der Feltz-Cornelis
authors.forename: Jan A
authors.initials: JA
authors.lastname: Swinkels
authors.forename: A H Nettie
authors.initials: AH
authors.lastname: Blankenstein
authors.forename: Rob
authors.initials: R
authors.lastname: Hoedeman
authors.forename: Emile J W
authors.initials: EJ
authors.lastname: Keuter
mesh_terms: D015897:Comorbidity; D005194:Family Practice / Q000592:standards*; D006297:Health Services Accessibility; D006801:Humans; D009426:Netherlands; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D013001:Somatoform Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*