Neurological Symptoms: Weakness, Blackouts and Dizziness
OVERVIEW The assessment of whether weakness and blackouts are due to a neurological disease process is not easy and usually requires referral to a neurologist. Dizziness is easier to assess…
Introduction
OVERVIEW Medically unexplained symptoms (MUS) are characterised by disturbances of function—including physiological, neurological and cognitive processes Using what is currently known about disturbed function, it is possible to develop coherent…
Considering Depression and Anxiety
OVERVIEW Depression and anxiety are common in patients with medically unexplained symptoms (MUS); most patients have elements of both MUS are not the same as depression and anxiety, although MUS…
Behavioural Approaches to Treatment
OVERVIEW CBT works by helping patients find ways to change their behaviour and put those changes into practice Behaviour change involves setting SMART (Specific, Measurable, Achievable, Realistic and Time orientated)…
Cognitive Approaches to Treatment
OVERVIEW CBT can be effective for a wide range of functional symptoms Cognitive approaches do not aim to uncover the cause, they address perpetuating factors for symptoms CBT is not…
Principles of Assessment and Treatment
OVERVIEW Listen to the patient Consider the possibility of medically unexplained symptoms (MUS)—think about epidemiology and about what is common in particular age groups Look for typical clinical features—of both…
Pharmacological Treatment
OVERVIEW There is good evidence supporting the use of antidepressants in functional somatic symptoms; patients do not have to be depressed to derive benefit Other atypical analgesics such as gabapentin…
Managing Medically Unexplained Symptoms in The Consultation
OVERVIEW Enhanced consultation skills enable doctors to work with patients with medically unexplained symptoms (MUS) in creative, personalised and effective ways Deep listening and empathy strengthen the therapeutic value of…
