Medically Unexplained Symptoms Presenting at Secondary Care—A Comparison of White Europeans and People of South Asian Ethnicity

Abstract

To assess whether, among new out-patients at secondary care medical clinics, people of South Asian origin have a higher proportion of medically unexplained symptoms, and receive different care compared to white Europeans. A retrospective case note study was performed in a district general hospital with a high proportion of ethnic minorities in the local population. We examined the notes of 100 people each of South Asian and white European origin who were in the 20-39 years age range and attending as new medical out-patients. We recorded the presenting symptoms, investigation results, and management plan, and from this we classified them as either explained by recognized organic disease or medically unexplained. We also recorded the number of investigations and whether psychosocial factors were mentioned in the letter to the referring doctor. Complete data were available for 93 people of South Asian origin and 98 white Europeans. The proportion of each who had medically unexplained symptoms was 52% and 49% respectively. The mean number (SD) of investigations in each was 1.8 (1.5) and 1.7 (1.6). Psychosocial factors were mentioned in correspondence of 42% and 45% respectively. The prevalence of medically unexplained symptoms, in this UK clinic, is similar among younger adults of South Asian and white European origin. South Asians undergo similar investigation and psychosocial inquiry to their white counterparts, suggesting that younger South Asians are managed similarly to white Europeans with respect to this aspect of medical care.