unexplained symptom
Jump to navigation
Jump to search
Introduction
also see hypochondriasm & somatoform disorder
History
- what is your main concern?
- what made you come in now?
- is there something particular you hope I could do for you?
- encourage discussion of psychsocial issures
- elements of standard history including chart review
- assess or screen for anxiety disorder
- assess of screen for depression
- who are the patient's supporters?
Physical examination
- assess for signs of disease
Laboratory
- as indicated by signs & symptoms
- repeated testing not indicated if no change in clinical status[1][5]
Management
- goals
- restoration of function
- acquisition of coping mechanisms
- diminished focus on symptoms[1]
- treatment plan
- treat anxiety disorder & depression
- cognitive behavioral therapy[1]
- regular follow-up[1]
- adherence & response to negotiated treatment plan
- change in health status
- patient education
- negotiate new treatment plan
More general terms
Additional terms
- hypochondriasm; illness anxiety disorder
- somatoform (psychosomatic) disorder; somatic symptom & related disorders (SSRD)
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Medical Knowledge Self Assessment Program (MKSAP) 17, 18 American College of Physicians, Philadelphia 2015, 2018.
- ↑ Edwards TM, Stern A, Clarke DD, Ivbijaro G, Kasney LM. The treatment of patients with medically unexplained symptoms in primary care: a review of the literature. Ment Health Fam Med. 2010 Dec;7(4):209-21. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22477945 Free PMC Article
- ↑ Hatcher S, Arroll B. Assessment and management of medically unexplained symptoms. BMJ. 2008 May 17;336(7653):1124-8. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18483055 Free PMC Article
- ↑ Smith RC, Lyles JS, Gardiner JC et al Primary care clinicians treat patients with medically unexplained symptoms: a randomized controlled trial. J Gen Intern Med. 2006 Jul;21(7):671-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16808764 Free PMC Article
- ↑ 5.0 5.1 Isaac ML, Paauw DS. Medically unexplained symptoms. Med Clin North Am. 2014 May;98(3):663-72. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24758967