Med. praxi. 2011;8(12):537-540

Patient with medically unexplained symptoms in primary health care

MUDr.Radkin Honzák, CSc.
Ústav všeobecného lékařství 1. LF UK Praha

Medically unexplained physical symptoms present one of common problems in modern medical practice but often prove difficult to

manage. Mutual understanding between physician and patient is essential for good quality of care; however, both parties have different

views on health complaints and treatment. The author summarizes principles of work with such patients, offers algorithm for diagnosis

using the recent Diagnostic Criteria for Psychosomatic Research, and treatment.

Keywords: medically unexplained symptoms, MUS, general practitioner, diagnosis, DCPR, treatment

Published: December 15, 2011  Show citation

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Honzák R. Patient with medically unexplained symptoms in primary health care. Med. praxi. 2011;8(12):537-540.
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References

  1. Černá L. Funkční dyspepsie - přínos krátkodobé psychoterapie (Psychosomatická kazuistika). Prakt Lék 2001; 81(4): 200-203.
  2. Groopman J. How doctors think. Houghton Mifflin Comp., Boston - New York, 2008.
  3. Honzák R. Bolest, její diagnostika a léčení. In: Chromý K, Honzák R et al. Somatizace a funkční poruchy. Praha, Grada Publishing 2005: 77-104.
  4. Honzák R. Funkční kardiovaskulární obtíže a psychiatrická problematika. In: Chromý K, Honzák R, et al. Somatizace a funkční poruchy. Praha, Grada Publishing, 2005: 135-157.
  5. Chvála V. Je psychosomatika věcí psychiatrie? Čes slov Psychiat 2009; 105(5): 195.
  6. Kitzlerová E. Potřebují pacienti trpící diabetem mellitem psychosociální pomoc? Čes slov Psychiat 2008; 104(4): 180-185.
  7. Kosová J. Léčba úzkostných poruch. Psychiatrie 2011; 15(1): 13-20, http://cz.lundbeck.com/cz/Professionals/Press/documents/Psychiatrie_c_1_2011_Lecba_uzkostnych_poruch.pdf.
  8. Kroenke K. Patients presenting with somatic complaints: epidemiology, psychiatric comorbidity, and management. Int J Meth Psychiatr Res 2003; 12: 34-43. Go to original source... Go to PubMed...
  9. Laňková J, Siblíková J. Deprese, 2004, http://www.svl.cz/Files/nastenka/page_4766/Version1/Deprese.pdf.
  10. Lieb R, Meinlschmidt G, Araya R. Epidemiology of the association between somatoform disorders and anxiety and depressive disorders: an update. Psychosom Med. 2007; 69(9): 860-863. Go to original source... Go to PubMed...
  11. Lipowski ZJ. The concept and its clinical application. Am J Psychiatry 1988; 145: 1358-1368. Go to original source... Go to PubMed...
  12. Mols F, Denollet J. Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems. Health Qual Life Outcomes. 2010,23; 8(1): 9 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822747/?tool=pubmed. Go to original source... Go to PubMed...
  13. Monzoni CM, Dunean R, Grünewald R, Reuber M. Are there interactional reasons why doctor may find it hard to tell patients that their physical symptoms may have emotional causes? A conversation analytic study in neurology outpatients. Patient Educ Couns, 2011, Aug 9 (Epub ahead of print). Go to original source... Go to PubMed...
  14. Porcelli P, Rafanelli C. Criteria for psychosomatic research (DCPR) in the medical setting. Curr Psychiatry Rep, 2010; 12(3): 246-254AN. Go to original source... Go to PubMed...
  15. Salmon P, Humpris GM, Ring A, et al. Primary care consultations about medically unexplained symptoms: patient presentations and doctor responses that influence the probability of somatic intervention. Psychosom Med, 2007; 69(6): 571-577. Go to original source... Go to PubMed...
  16. Taylor RE, Marshall T, Mann A, Goldberg DP. Insecure attachment and frequent attendance in primary care: a longitudinal cohort study of medically unexplained symptoms presentations in ten UK general practices. Psychol Med, 2011; 31(8): 1-10.
  17. Trapková L, Chvála V. Rodinná terapie psychosomatických poruch, Portál, Praha, 2005.
  18. http://www.healthquality.va.gov/mus/mus_poc_combined.pdf.




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