Addressing the needs of patients with medically unexplained symptoms: 10 key messages.

Many GPs find the care of patients with medically unexplained symptoms (MUS) challenging. Therefore, the WONCA Working Party for Primary Mental Health asked for MUS guidance for family doctors worldwide in order to improve the care of patients with MUS globally. This article is a summary of this guidance. MUS are physical symptoms that have existed for several weeks and for which adequate medical examination or investigation have not revealed any condition that sufficiently explains the symptoms. MUS is a working hypothesis based on the (justified) assumption that somatic or psychiatric pathology have been adequately detected and treated, but that the clinical condition presented by the patients was not adequately resolved. Any change in symptoms could be a reason to revise the working hypothesis of MUS.1 For some patients with physical symptoms, a somatic or psychiatric condition may be present. However, if the physical symptoms are more severe or more persistent, or limit functioning to a greater extent than expected based on the condition in question, they too are referred to as MUS. MUS can be seen as a continuum ranging from self-limiting symptoms to recurrent and/or persisting symptoms and symptom disorders. The group with recurrent and/or persisting symptoms is especially relevant in primary care as these …