Medically unexplained symptoms in frequent attenders of secondary health care: retrospective cohort study.

Abstract

To estimate the prevalence of medically unexplained symptoms in patients who most frequently attend outpatient services. Retrospective cohort study over three years with review of case notes. Secondary care services in the South Thames (West) NHS region. Outpatient attenders with new appointments in 1993. Number of outpatient appointments, and number of consultation episodes for medically unexplained conditions. Medical records of 361 of 400 sampled frequent attenders were examined, and 971 consultation episodes were recorded. Ninety seven (27%) had one or more consultation episodes in which the condition was medically unexplained; 208 (21%) of the 971 consultation episodes were medically unexplained. Abdominal pain, chest pain, headache, and back pain were commonly found to be medically unexplained. Medically unexplained symptoms present in most hospital specialties and account for a considerable proportion of consultations by frequent attenders in secondary care.