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Medically Unexplained Symptoms, Somatisation and Bodily Distress
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    This book has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Creed, Francis and Gureje, Oye 2012. Emerging themes in the revision of the classification of somatoform disorders. International Review of Psychiatry, Vol. 24, Issue. 6, p. 556.

    Carrington, Anca Rock, Brian and Stern, Julian 2012. Psychoanalytic thinking in primary care: The Tavistock Psychotherapy Consultation model. Psychoanalytic Psychotherapy, Vol. 26, Issue. 2, p. 102.

    Kapfhammer, H.P. 2012. Psychopharmakotherapeutische Ansätze bei somatoformen Störungen und funktionellen Körpersyndromen. Der Nervenarzt, Vol. 83, Issue. 9, p. 1128.

    Town, Joel M. and Driessen, Ellen 2013. Emerging Evidence for Intensive Short-Term Dynamic Psychotherapy with Personality Disorders and Somatic Disorders. Psychiatric Annals, Vol. 43, Issue. 11, p. 502.

    Douzenis, Athanassios and Seretis, Dionysis 2013. Descriptive and predictive validity of somatic attributions in patients with somatoform disorders: A systematic review of quantitative research. Journal of Psychosomatic Research, Vol. 75, Issue. 3, p. 199.

    de Jesus Mari, Jair Tófoli, Luís Fernando Noto, Cristiano Li, Li M. Diehl, Alessandra Claudino, Angélica M. and Juruena, Mario F. 2013. Pharmacological and Psychosocial Management of Mental, Neurological and Substance Use Disorders in Low- and Middle-Income Countries: Issues and Current Strategies. Drugs, Vol. 73, Issue. 14, p. 1549.

    Creed, F. H. Tomenson, B. Chew-Graham, C. Macfarlane, G. J. Davies, I. Jackson, J. Littlewood, A. and McBeth, J. 2013. Multiple Somatic Symptoms Predict Impaired Health Status in Functional Somatic Syndromes. International Journal of Behavioral Medicine, Vol. 20, Issue. 2, p. 194.

    Stern, Julian Hard, Emily and Rock, Brian 2015. Paradigms, politics and pragmatics: psychotherapy in primary care in City and Hackney – a new model for the NHS. Psychoanalytic Psychotherapy, Vol. 29, Issue. 2, p. 117.

    Budtz-Lilly, Anna Schröder, Andreas Rask, Mette Trøllund Fink, Per Vestergaard, Mogens and Rosendal, Marianne 2015. Bodily distress syndrome: A new diagnosis for functional disorders in primary care?. BMC Family Practice, Vol. 16, Issue. 1,

    Bass, Christopher and Pearce, Steve 2016. Severe and enduring somatoform disorders: recognition and management. BJPsych Advances, Vol. 22, Issue. 2, p. 87.

    Rossen, Camilla Blach Buus, Niels Stenager, Elsebeth and Stenager, Egon 2017. Identity work and illness careers of patients with medically unexplained symptoms. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, p. 136345931773944.

    Bohman, Hannes Låftman, Sara B. Cleland, Neil Lundberg, Mathias Päären, Aivar and Jonsson, Ulf 2018. Somatic symptoms in adolescence as a predictor of severe mental illness in adulthood: a long-term community-based follow-up study. Child and Adolescent Psychiatry and Mental Health, Vol. 12, Issue. 1,

    Caruso, Garson M. 2018. Handbook of Behavioral Health Disability Management. p. 201.

    Scheffers, M. Kalisvaart, H. van Busschbach, J. T. Bosscher, R. J. van Duijn, M. A. J. van Broeckhuysen-Kloth, S. A. M. Schoevers, R. A. and Geenen, R. 2018. Body image in patients with somatoform disorder. BMC Psychiatry, Vol. 18, Issue. 1,

    van der Feltz-Cornelis, Christina M. Elfeddali, Iman Werneke, Ursula Malt, Ulrik F. Van den Bergh, Omer Schaefert, Rainer Kop, Willem J. Lobo, Antonio Sharpe, Michael Söllner, Wolfgang and Löwe, Bernd 2018. A European Research Agenda for Somatic Symptom Disorders, Bodily Distress Disorders, and Functional Disorders: Results of an Estimate-Talk-Estimate Delphi Expert Study. Frontiers in Psychiatry, Vol. 9, Issue. ,

    Allwang, Christine Hamilton, Amber and Malhi, Gin S. 2018. Mind the body to detect embodiment in the mind. Bipolar Disorders, Vol. 20, Issue. 7, p. 672.

    Dowrick, Christopher and Rosendal, Marianne 2018. Primary Care Mental Health. p. 138.

    Leutgeb, Ruediger Berger, Sarah Szecsenyi, Joachim Laux, Gunter and Schmaling, Karen B. 2018. Patients with somatoform disorders: More frequent attendance and higher utilization in primary Out-of-Hours care?. PLOS ONE, Vol. 13, Issue. 8, p. e0202546.

    Carlier, I.V.E. Andree Wiltens, D.H. van Rood, Y.R. van Veen, T. Dekker, J. and van Hemert, A.M. 2018. Treatment course and its predictors in patients with somatoform disorders: A routine outcome monitoring study in secondary psychiatric care. Clinical Psychology & Psychotherapy, Vol. 25, Issue. 4, p. 550.

    Balabanovic, Janet and Hayton, Philip 2019. Engaging patients with “medically unexplained symptoms” in psychological therapy: An integrative and transdiagnostic approach. Psychology and Psychotherapy: Theory, Research and Practice,

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    Medically Unexplained Symptoms, Somatisation and Bodily Distress
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Book description

Medically unexplained symptoms and somatisation are the fifth most common reason for visits to doctors in the USA, and form one of the most expensive diagnostic categories in Europe. The range of disorders involved includes irritable bowel syndrome, chronic widespread pain and chronic fatigue syndrome. This book reviews the current literature, clarifies and disseminates clear information about the size and scope of the problem, and discusses current and future national and international guidelines. It also identifies barriers to progress and makes evidence-based recommendations for the management of medically unexplained symptoms and somatisation. Written and edited by leading experts in the field, this authoritative text defines international best practice and is an important resource for psychiatrists, clinical psychologists, primary care doctors and those responsible for establishing health policy.

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  • 8 - Identification, assessment and treatment of individual patients
    pp 175-216
  • View abstract


    This chapter considers three groups, medically unexplained symptoms, somatoform disorders, and functional somatic syndromes. Describing the nature of these groups, it talks about their prevalence in cross-sectional studies in primary, secondary care and population-based studies. Medically unexplained symptoms are very common both in the general population and in primary and secondary care, but at least in the first two settings most are transient. Systematic reviews of the prevalence of irritable bowel syndrome in population-based samples have indicated that the prevalence varies considerably with the definition of the syndrome. Functional somatic syndromes are also common but only some patients with these syndromes also have numerous somatic symptoms. There is little doubt that somatoform disorders, or bodily distress syndromes, are an important and challenging group of conditions that are expensive in terms of healthcare use and time missed from work.
  • 9 - Training
    pp 217-235
  • View abstract


    This chapter discusses the terminology, stressing the difficulties of the words and concept of medically unexplained symptoms (MUS), and discussing the pros and cons of alternative terms. A fundamental problem with the concept underlying medically unexplained symptoms is the dualism it fosters. The chapter provides the empirical foundation of positive psychobehavioural descriptors, and refers to their suitability as diagnostic criteria in more detail. It has been shown that patients with chronic unexplained symptoms report a negative self-concept of being weak, not tolerating stress and not tolerating any physical challenges. Avoidance of physical activities was the most powerful discriminator between patients with somatic complaints needing medical help and feeling disabled, and those with somatic complaints but without healthcare needs or disability. An important conceptual issue concerns the influence on classification of the psychophysiological models for the experience of disabling bodily symptoms.
  • 10 - Achieving optimal treatment organisation in different countries
    pp 236-252
  • View abstract


    This chapter provides an overview of the current state of evidence regarding treatment of medically unexplained symptoms, somatisation and the functional somatic syndromes. Both primary and secondary care studies have been performed to assess the efficacy of psychological interventions, most commonly cognitive behaviour therapy administered by a mental health professional, or antidepressants, prescribed by the patient's usual doctor. Thirteen trials evaluated cognitive behaviour therapy, five evaluated antidepressants, four the effect of a consultation letter to the general practitioner (GP) and three the training of GPs. The chapter reviews psychological treatments and the use of antidepressants. It uses three systematic reviews to provide an overview of the evidence of efficacy of interventions for functional somatic symptoms. The evidence is stronger for some pharmacological treatments than for psychological treatments partly because of the universal use of placebo tablets and the lack of an attention-placebo in psychological treatment trials.


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