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Medically unexplained symptoms and somatisation in ENT

Published online by Cambridge University Press:  10 April 2013

G Ullas
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Nottingham University Hospitals NHS Trust, UK
L McClelland
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Nottingham University Hospitals NHS Trust, UK
N S Jones*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Nottingham University Hospitals NHS Trust, UK
*
Address for correspondence: Prof N S Jones, Department of Otorhinolaryngology, Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK E-mail: nick.jones@nottingham.ac.uk

Abstract

Background:

Somatisation has been described as the perception of a physiological event influenced by emotion.

Method:

A review of the medical literature was carried out using the following Medical Subject Headings: somatisation (which identified 357 articles), medically unexplained symptoms (749 articles), unexplained or idiopathic dizziness (142 articles), tinnitus (360 articles), catarrh (1068 articles) and globus pharyngeus (3114 articles).

Results:

Up to 40 per cent of out-patient attendances have medically unexplainable symptoms. In ENT clinics, this includes patients with dizziness, tinnitus, ‘pseudo’ eustachian tube dysfunction, being ‘unable to hear’, catarrh and postnasal drip, atypical facial pain, globus pharyngeus, and functional dysphonia. Medical explanations of these symptoms often differ from patients' perceptions. Demonstrating normal test results and providing reassurance have little effect on patients' doubts and anxieties. Consultations that recognise the symptoms and their impact, and offer a tangible and involving explanation are more likely to satisfy and empower patients.

Conclusion:

The treatment of medically unexplained symptoms has changed in recent years; there is now more emphasis on psychological factors due to an association with anxiety and depression.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited 2013 

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