Medically unexplained symptoms.
In summary, caring for patients with MUS is challenging for health care providers. Even defining somatization syndromes is complex and controversial, reflecting the medical community’s limited understanding of the pathophysiology for this group of disorders. Although risk factors for MUS have been described and are well understood, little is known about how MUS can be prevented. Uncertainty in medicine, as in any human enterprise, is a given, but the difficulties in identification and treatment of patients with MUS highlight the limitations in understanding the intersection between physical and mental health. Patients come to their physician looking for clarity, understanding, and relief of debilitating symptoms. The understanding of MUS will evolve, and perhaps an organic cause not yet understood or described may emerge to lend clarity and therapeutic opportunities to some patients with somatic disorders. In the meantime, the most powerful tools available are the ability to communicate the limits of current understanding, acknowledge the difficulties faced by patients with this disorder, and reinforce the willingness and desire of clinicians to partner with patients as the focus shifts from diagnosis to symptom management. Thus, the physician-patient relationship, still in its rightful place at the heart of the practice of medicine, lies at the center of effective treatment of patients with MUS.
Department of Medicine, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Box 359892, Seattle, WA 98104, USA. Electronic address: misaac@uw.edu.
Margaret L
ML
Isaac
Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA.
Douglas S
DS
Paauw
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy
Depression; Medically unexplained symptoms; Pain; Somatization; Somatoform