TY - JOUR
KW - Diagnosis, Differential
KW - Diagnostic and Statistical Manual of Mental Disorders
KW - Humans
KW - Mental Disorders/classification/diagnosis
KW - Patient Care/methods
KW - Primary Health Care/methods
KW - Somatoform Disorders/classification/diagnosis
AU - R. C. Smith
AU - F. C. Dwamena
A1 - 
AB - Patients with medically unexplained symptoms (MUS) have little or no demonstrable disease explanation for the symptoms, and comorbid psychiatric disorders are frequent. Although common, costly, distressed, and often receiving ill-advised testing and treatments, most MUS patients go unrecognized, which precludes effective treatment. To enhance recognition, we present an emerging perspective that envisions a unitary classification for the entire spectrum of MUS where this diagnosis comprises severity, duration, and comorbidity. We then present a specific approach for making the diagnosis at each level of severity. Although our disease-based diagnosis system dictates excluding organic disease to diagnose MUS, much exclusion can occur clinically without recourse to laboratory or consultative evaluation because the majority of patients are mild. Only the less common, "difficult" patients with moderate and severe MUS require investigation to exclude organic diseases. By explicitly diagnosing and labeling all severity levels of MUS, we propose that this diagnostic approach cannot only facilitate effective treatment but also reduce the cost and morbidity from unnecessary interventions.
BT - Journal of general internal medicine
C5 - Medically Unexplained Symptoms
CP - 5
CY - United States
DO - 10.1007/s11606-006-0067-2
IS - 5
JF - Journal of general internal medicine
N2 - Patients with medically unexplained symptoms (MUS) have little or no demonstrable disease explanation for the symptoms, and comorbid psychiatric disorders are frequent. Although common, costly, distressed, and often receiving ill-advised testing and treatments, most MUS patients go unrecognized, which precludes effective treatment. To enhance recognition, we present an emerging perspective that envisions a unitary classification for the entire spectrum of MUS where this diagnosis comprises severity, duration, and comorbidity. We then present a specific approach for making the diagnosis at each level of severity. Although our disease-based diagnosis system dictates excluding organic disease to diagnose MUS, much exclusion can occur clinically without recourse to laboratory or consultative evaluation because the majority of patients are mild. Only the less common, "difficult" patients with moderate and severe MUS require investigation to exclude organic diseases. By explicitly diagnosing and labeling all severity levels of MUS, we propose that this diagnostic approach cannot only facilitate effective treatment but also reduce the cost and morbidity from unnecessary interventions.
PP - United States
PY - 2007
SN - 1525-1497; 0884-8734
SP - 685
EP - 691
EP - 
T1 - Classification and diagnosis of patients with medically unexplained symptoms
T2 - Journal of general internal medicine
TI - Classification and diagnosis of patients with medically unexplained symptoms
U1 - Medically Unexplained Symptoms
U2 - 17443380
U3 - 10.1007/s11606-006-0067-2
VL - 22
VO - 1525-1497; 0884-8734
Y1 - 2007
ER -