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Family Practice Advance Access originally published online on April 21, 2006
Family Practice 2006 23(4):414-420; doi:10.1093/fampra/cml016
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© The Author (2006). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Persistent presentation of medically unexplained symptoms in general practice

Peter F M Verhaaka, Susan A Meijera, Adriaan P Visserb and Gerrit Woltersc

a Netherlands Institute of Health Services Research PO Box 1568, 3500 BN Utrecht
b Helen Dowling Institute, Centre for Psycho-oncology Utrecht
c Interpolis Insurance Company Tilburg, The Netherlands

Correspondence to Peter FM Verhaak; Email: p.verhaak{at}nivel.nl

Objectives. To estimate the prevalence of persistent presentation of medically unexplained physical symptoms (MUPS) in general practice. To assess socio-demographic characteristics, health status and use of health services of patients who frequently present MUPS, compared with reference groups.

Design. One-year, nationwide, representative survey of morbidity in general practice in the Netherlands, including 400 000 enlisted patients in 104 general practices.

Results. Of all patients (age: 18 years and older), 2.45% who visited their GP at least once a year, presented at least 4 times in 1 year with symptoms which are commonly considered medically unexplained without getting a medical diagnosis during that period, that might explain the symptoms. These patients are significantly older, more often female, less educated, more frequently unemployed and more frequently from a non-Western origin than ‘average’ patients or patients with a medical diagnosis.

Conclusion. Although 25–50% of all reasons for visit to a GP concern symptoms that are not medically explained, the frequent presentation of such symptoms is much more rare. Frequent attendance because of MUPS is most common among elderly women with a lower socio-economic status.

Keywords. Epidemiology, family practice, frequent attenders, medically unexplained physical symptoms (MUPS).


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