What is the problem?

Physical symptoms which are not caused by physical disease or injury are extremely common with many people experiencing them most days (e.g. headache, cramp, tiredness) but not normally requiring medical intervention.  However quite commonly, people present and re-present to primary care or emergency departments because of concern that these physical symptoms may be caused by a physical disease.

19 per cent of new primary care GP appointments, especially frequent attenders, were found to be for people whose symptoms were previously described as ‘medically unexplained symptoms’ (MUS) but may be better described as physiologically explainable symptoms (PES)2-3.

In secondary care (physical health trusts/services), a number of studies in both the UK and the United States have shown that up to 50 per cent of sequential new attenders at outpatient services have PES (‘MUS’).  For example, percentage with PES (‘MUS’) in new attenders at the outpatient department, King’s College Hospital, London4 by specialty were found to be:

  • Chest (59%)
  • Cardiology (56%)
  • Gastroenterology (60%)
  • Rheumatology (58%)
  • Neurology (55%)
  • Gynaecology (57%)
  • Dental (49%)

Analysis of 2008/2009 NHS figures shows that people with these problems account for as many as:

  • one in five new consultations in primary care,
  • 7 per cent of all prescriptions,
  • 25 per cent of outpatient care,
  • 8 per cent of inpatient bed days, often repeat admissions,  and
  • 5 per cent of A&E attendances,

Women are three to four times more likely to experience PES (‘MUS’) than men.5