title: Medically unexplained symptoms--a perspective from general practitioners in the developing world.
abstract: OBJECTIVE
  In this study, we explored the attitudes toward Medically Unexplained Symptoms (MUS) of 500 general practitioners (GPs) in Karachi, Pakistan. Using a questionnaire previously developed by Reid et al. (2001), we aimed to investigate whether GPs' attitudes toward medically unexplained symptoms are similar to those of GPs in the developed world.
  
  
  METHODS
  Five hundred GPs on the database of primary care centers at the Pakistan Institute of Learning and Living in Karachi were all sent a covering letter explaining the purpose of the survey with a case vignette, a questionnaire, and a stamped addressed envelope. One month later, non-respondents received a telephone call from an investigator to remind them of the study.
  
  
  RESULTS
  Of the 429 respondents, 68.5% (294) were male and 31.5% (135) female. Although 80.2% of respondents felt that the main role of GPs was to provide support and reassurance, 76.9% of respondents also agreed that GPs had a role in referring patients with MUS for further investigations to identify a cause. Two hundred and four (47.55%) respondents agreed that somatization was useful concept, only 146 (34.03%) felt that there was effective treatment for it.
  
  
  CONCLUSIONS
  For the most part, Pakistani GPs' attitudes toward MUS are not very different to those of their counterparts in the West. Both agree that the GP has an important role in providing reassurance and counseling. However, our survey also shows that Pakistani GPs are less likely to place emphasis on an underlying psychiatric diagnosis and tend to focus on looking for an underlying physical cause.
authors.affiliation: Department of Psychiatry, South West London and St George's NHS Trust, Springfield University Hospital, London, UK. ishrat-h@doctors.net.uk
authors.forename: Muhammad Ishrat
authors.initials: MI
authors.lastname: Husain
authors.forename: Venugopal
authors.initials: V
authors.lastname: Duddu
authors.forename: Muhammad Omair
authors.initials: MO
authors.lastname: Husain
authors.forename: Imran Bashir
authors.initials: IB
authors.lastname: Chaudhry
authors.forename: Raza
authors.initials: R
authors.lastname: Rahman
authors.forename: Nusrat
authors.initials: N
authors.lastname: Husain
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003906:Developing Countries; D005260:Female; D020793:Gatekeeping; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012017:Referral and Consultation; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology*; D011795:Surveys and Questionnaires