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Family Practice Advance Access published online on April 21, 2006
Family Practice, doi:10.1093/fampra/cml016
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© The Author (2006). Published by Oxford University Press. All rights reserved.
Received September 14, 2005
Accepted March 21, 2006

Article

Persistent presentation of medically unexplained symptoms in general practice

Peter F M Verhaak 1 *, Susan A Meijer 1, Adriaan P Visser 2, and Gerrit Wolters 3

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

* To whom correspondence should be addressed.
Peter F M Verhaak, E-mail: p.verhaak{at}nivel.nl


  Abstract

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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