ABC of Medically Unexplained Symptoms

• Autore: Burton Christopher
• Pubblicazione: New York : , : John Wiley & Sons, Incorporated, , 2013; ©2012
• Edizione: 1st ed.
• Descrizione fisica: 1 online resource (90 pages)
• Disciplina: 616.07/5
• Soggetto topico: Primary Health Care - methods
• Soggetto genere / forma: Electronic books.
• Nota di contenuto: Intro -- Medically Unexplained Symptoms -- Contents -- Contributors -- Acknowledgements -- Chapter 1 Introduction -- Aim -- An approach to MUS -- What do we mean by medically unexplained symptoms? -- Symptoms with low probability of disease -- Functional somatic syndromes -- What causes MUS? -- Biological mechanisms -- Symptom awareness and appraisal -- Perpetuating factors -- An integrated model -- What should we call MUS? -- How to use this book -- Further reading -- Chapter 2 Epidemiology and Impact in Primary and Secondary Care -- Epidemiology -- Population prevalence -- GP consultation prevalence -- Referral prevalence -- Prevalence and overlap of syndromes -- Epidemiological associations of MUS -- Impact of MUS -- Quality of life -- Healthcare usage and costs -- Conclusion -- Further reading -- Chapter 3 Considering Organic Disease -- Introduction -- How commonly does MUS turn out to be organic disease? -- What are the factors associated with practitioner delay in diagnosing serious illness? -- Patient characteristics -- Patient healthcare behaviour -- Practitioner response -- Health system factors -- What are the commonest diagnostic errors? -- Cognitive processing errors -- Premature closure -- Availability bias -- Representativeness bias -- Anchoring and conservatism -- Principles for safe practice with suspected MUS -- Summary -- Further reading -- Chapter 4 Considering Depression and Anxiety -- Introduction -- Epidemiology -- Diagnosis -- Depression -- Generalised and phobic anxiety -- Family history, childhood and recent stress -- Suicide and self-harm -- Patients' beliefs -- Questionnaires -- Investigations -- Explaining the diagnosis -- Further reading -- Chapter 5 Medically Unexplained Symptoms and the General Practitioner -- MUS and diagnostic confusion -- Uncertain case definition -- Variable clinical context. ; The frustration of MUS -- Patients' expectations of GPs -- How GPs can make the situation worse -- Living with uncertainty -- Further reading -- Chapter 6 Principles of Assessment and Treatment -- Introduction -- Listening to the patient -- Considering the possibility of MUS -- Look for typical features of organic and functional conditions -- Target your examination and investigations -- Give constructive explanations -- Link the explanation to action -- Set appropriate expectations and safety nets -- Expectation of recovery -- Expectation of you -- Setting safety nets -- Bringing it all together -- Further reading -- Chapter 7 Palpitations, Chest Pain and Breathlessness -- Introduction -- Palpitations -- Epidemiology in primary care -- GP assessment -- Typical features of functional symptoms -- Typical features of organic symptoms and red flag symptoms -- History and examination tips -- Clinical decision -- Referral and Investigations -- Explanation -- Specific treatment -- Chest pain -- GP assessment of new chest pain -- History and examination tips -- Investigations and referral -- Explanation -- Specific treatment -- Breathlessness -- Epidemiology in primary care -- GP assessment -- Typical features of functional symptoms -- Examination tips -- Explanation -- Conclusion -- Further reading -- Chapter 8 Headache -- Introduction -- Epidemiology in primary care -- GP assessment -- Typical features of functional symptoms -- Tension-type headache -- Medication-overuse headache -- Typical features of organic symptoms -- Headaches representing serious disease -- Migraine -- Other primary headaches -- History and examination tips -- The examination -- Clinical decision -- Explanation -- Specific treatment -- Further reading -- Chapter 9 Gastrointestinal Symptoms: Functional Dyspepsia and Irritable Bowel Syndrome -- Introduction -- Functional dyspepsia. ; Epidemiology in primary care -- GP assessment -- History and examination tips -- Investigations and referral -- Explanation -- Specific treatment -- Irritable bowel syndrome -- Epidemiology in primary care -- History and examination -- GP assessment -- Investigations and referral -- Explanation -- Specific treatment -- Other functional gut syndromes -- Conclusion -- Further reading -- Chapter 10 Pelvic and Reproductive System Symptoms -- Introduction -- Chronic pelvic pain -- Epidemiology in primary care -- GP assessment -- Typical features of organic symptoms -- History and examination tips -- Explanations of functional CPP -- Specific management -- Vulvodynia -- Epidemiology in primary care -- GP assessment -- Typical features of organic symptoms -- Typical features of functional symptoms -- History, examination and investigation -- Explanations and management -- Dyspareunia -- Epidemiology in primary care -- GP assessment -- Explanation after a negative investigation -- Specific management -- Other pelvic and reproductive symptoms -- Further reading -- Chapter 11 Widespread Musculoskeletal Pain -- Introduction -- Epidemiology in primary care -- Typical features of functional symptoms -- Typical features of organic symptoms -- History and examination tips -- Investigations -- Explanation -- Specific management -- Reassurance -- Non-pharmacological options -- Pharmacological options -- Summary -- Further reading -- Chapter 12 Fatigue -- Epidemiology in primary care -- Fatigue symptoms -- Chronic fatigue syndrome -- GP assessment -- Typical features of functional symptoms -- Typical features of organic symptoms and red flag symptoms -- History and examination tips -- Referral and investigations -- Clinical decision -- Explanation -- Specific treatment -- Conclusion -- Further reading. ; Chapter 13 Neurological Symptoms: Weakness, Blackouts and Dizziness -- Introduction -- Functional weakness -- Epidemiology -- Clinical features of functional weakness -- GP assessment -- Explanation -- Specific treatment -- Blackouts/dissociative (non-epileptic attacks) -- Epidemiology -- Clinical features of dissociative (non-epileptic) attacks -- GP assessment -- Explanation -- Dizziness -- Epidemiology in primary care -- GP assessment -- Typical features of functional dizziness -- Explanation -- Treatment -- Further reading -- Chapter 14 Managing Medically Unexplained Symptoms in The Consultation -- Introduction -- Getting the consultation off to a good start -- Deep listening skills -- Using non-verbal (body language) and paraverbal (tone of voice) information -- Picking up when listening is not working -- Avoiding the problem of 'The doctor thinks I am imagining it' -- Examination with commentary -- Breaking good news -- Planning care and follow-up -- Working on the relationship -- Further reading -- Chapter 15 Cognitive Approaches to Treatment -- CBT - 'it's NOT all in your mind' -- A CBT formulation -- Developing and sharing a formulation -- Using a formulation to introduce treatment -- Engaging patients -- Working on specific thoughts -- Beliefs about cause -- Beliefs about symptom meaning and management -- Hurt equals harm -- Catastrophisation -- Beliefs about self and self-standards -- Beliefs of others -- Where to start -- Further reading -- Chapter 16 Behavioural Approaches to Treatment -- Introduction -- CBT, it is NOT just 'do more exercise' -- Know where you are going -- Activity management(s) -- Monitoring activity -- Overactivity -- Underactivity -- Inconsistent or 'boom and bust' activity -- Loss of pleasurable activity -- Activity scheduling -- Graded activity -- Establish a baseline -- Graded increases on baseline -- Review. ; Sleep management -- Summary -- Further reading -- Chapter 17 Pharmacological Treatment -- Introduction -- How drugs appear to work for symptoms -- Reducing depression or anxiety -- Reducing central sensitisation to pain -- Altering symptom appraisal and autonomicresponses -- Choosing which drug to use -- Antidepressants -- Anticonvulsants -- Explaining treatment -- Reviewing and discontinuing drugs -- Addiction to prescribed treatment -- Side effects and the nocebo response -- Treatment of less common psychiatric disorders -- Further reading -- Chapter 18 Conclusion -- Appendix: Suggestions for Reflection and Audit -- Index.
• Sommario/riassunto: This brand new title addresses the complex issues faced by primary health care practitioners in treating and managing patients with 'medically unexplained symptoms'. It aims to develop guidelines and principles to help identify patients with medically unexplained symptoms, as they are typically underdiagnosed, and to manage symptoms more effectively with active patient involvement.
• Titolo autorizzato: ABC of Medically Unexplained Symptoms
• ISBN: 9781118495308; 9781119967255
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Lingua di pubblicazione: Inglese
• Record Nr.: 9910822073003321
• Lo trovi qui: Univ. Federico II
• Serie: ABC Ser.