title: Medically unexplained conditions considered by patients in general practice.
abstract: BACKGROUND
  Patients frequently present with multiple and 'unexplained' symptoms, often resulting in complex consultations. To better understand these patients is a challenge to health care professionals, in general, and GPs, in particular.
  
  
  OBJECTIVE
  In our research on symptom reporting, we wanted to explore whether patients consider that they may suffer from conditions commonly regarded as unexplained, and we explored associations between these concerns and symptom load, life stressors and socio-demographic factors.
  
  
  METHODS
  Consecutive, unselected patients in general practice completed questionnaires addressing eight conditions commonly regarded as unexplained (amalgam poisoning, Candida syndrome, fibromyalgia, food intolerance, electromagnetic hypersensitivity, burnout syndrome, chronic fatigue syndrome and irritable bowel syndrome). With logistic regression, we analysed associations with symptom load, burden of life stressors with negative impact on present health and socio-demographic variables.
  
  
  RESULTS
  Out of the 909 respondents (response rate = 88.8%), 863 had complete data. In total, 39.6% of patients had considered that they may suffer from one or more unexplained conditions (UCs). These concerns were strongly and positively associated with recent symptom load and number of life stressors. If we excluded burnout and food intolerance, corresponding associations were found.
  
  
  CONCLUSIONS
  Patients frequently considered that they may suffer from UCs. The likelihood of such concerns strongly increased with an increasing symptom load and with the number of life stressors with negative impact on present health. Hence, the number of symptoms may be a strong indicator of whether patients consider their symptoms part of such often controversial multisymptom conditions.
authors.affiliation: Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, PO Box 1130, Blindern, N-0318 Oslo and.
authors.forename: Hedda
authors.initials: H
authors.lastname: Tschudi-Madsen
authors.forename: Mona
authors.initials: M
authors.lastname: Kjeldsberg
authors.forename: Bård
authors.initials: B
authors.lastname: Natvig
authors.forename: Camilla
authors.initials: C
authors.lastname: Ihlebaek
authors.forename: Jørund
authors.initials: J
authors.lastname: Straand
authors.forename: Dag
authors.initials: D
authors.lastname: Bruusgaard
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003723:Dental Amalgam / Q000009:adverse effects*; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology*; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology*; D058006:General Practice; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution; D013001:Somatoform Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003723:Dental Amalgam
keywords: Causal attribution; general practice; medically unexplained symptoms; multisymptomatology; symptom reporting.