Abstract
This commentary presents commonalities in medically unexplained symptoms (MUS) across multiple organ systems, including symptoms, aetiological mechanisms, comorbidity with mental health disorders, symptom burden and impact on quality of life. Further, treatment outcomes and barriers in the clinician–patient relationship, and cross-cultural experiences are highlighted. This discussion is necessary in aiding an improved understanding and management of MUS due to the interconnectedness underlying MUS presentations across the spectrum of medical specialties.
Highlights
Unexplained symptoms (MUS) refer to a broad spectrum of physical symptoms that cannot or have not been sufficiently explained by organic causes after adequate physical examination and investigations [1,2]
Whereas a patient with fatigue and widespread pain in the absence of known medical causes might be diagnosed with chronic fatigue syndrome or fibromyalgia in an internal medicine or rheumatology setting, the same patient would be diagnosed with a somatic symptom disorder by a psychiatrist
This paper has highlighted a number of possible factors which contribute to the evolution and perpetuation of Medically unexplained symptoms (MUS)
Summary
Unexplained symptoms (MUS) refer to a broad spectrum of physical symptoms that cannot or have not been sufficiently explained by organic causes after adequate physical examination and investigations [1,2]. The aetiology of irritable bowel syndrome has already been explained with a complex interaction between central and psychosocial processes and gut physiology [8], as a result of advances in syndrome-specific research of pathomechanisms over the past decade. It bears several disadvantages when researchers and clinicians develop, dependent on their clinical speciality, an isolated perspective on single, specific syndromes of MUS. FSS, such as fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome [11] This finding favours the adoption of a unifying framework where the concept of MUS can be viewed as a single diagnostic category rather than distinct FSS. Consideration is given to how MUS may arise whilst exploring possible aetiological factors, predictors and consequences of MUS involving a broad framework
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