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SYMPTOM DIAGNOSES: OFTEN THE BEST DESCRIPTION OF PATIENTS’ PROBLEMS

SYMPTOM DIAGNOSES: OFTEN THE BEST DESCRIPTION OF PATIENTS’ PROBLEMS. INGE OKKES JEAN KARL SOLER HENK LAMBERTS. WHY MUS IS NOT A HELPFUL CONCEPT. REASON FOR ENCOUNTER. DIAGNOSIS. RFE. SYMPTOM DIAGNOSIS. SYMPTOM/ COMPLAINT. sometimes repeatedly, and for quite some time.

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SYMPTOM DIAGNOSES: OFTEN THE BEST DESCRIPTION OF PATIENTS’ PROBLEMS

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  1. SYMPTOM DIAGNOSES: OFTEN THE BEST DESCRIPTION OF PATIENTS’ PROBLEMS INGE OKKES JEAN KARL SOLER HENK LAMBERTS

  2. WHY MUSIS NOT A HELPFUL CONCEPT

  3. REASON FOR ENCOUNTER

  4. DIAGNOSIS RFE

  5. SYMPTOM DIAGNOSIS SYMPTOM/ COMPLAINT sometimes repeatedly, and for quite some time

  6. …(some) doctors get frustrated….

  7. MEDICALLY UNEXPLAINED SYMPTOMSConcept: a substantial proportion of patients present (over an extended period of time) with physical complaints not attributable to a defined disease. Hypothesis: these patients have a psychosocial/ psychiatric problem that expresses itself through the presentation of physical symptoms

  8. SOMATIZATION IN A NEW GUISE

  9. HEADACHE

  10. SHORTNESS OF BREATH

  11. SLEEP DISTURBANCES

  12. LOSS OF APPETITE

  13. RESTLESSNESS

  14. PALPITATIONS

  15. LUMP IN THROAT

  16. TIREDNESS

  17. FLATULENCE/GAS/BELCHING

  18. EXTREMITY PAIN

  19. LOOSE BOWELS

  20. NAUSEA

  21. ABDOMINAL PAIN

  22. CONSTIPATION

  23. WEIGHT CHANGE

  24. BACKPAIN

  25. BACKPAIN

  26. MUS

  27. MUS SHORTNESS OF BREATH CHEST PAIN TIREDNESS HEADACHE ABDOMINAL PAIN NUMBNESS LOSS OF APPETITE LUMP IN THROAT EXTREMITY PAIN NAUSEA CONSTIPATION WEIGHT CHANGE LOOSE BOWELS PALPITATIONS BACKPAIN FLATULENCE/GAS/BELCHING SLEEP DISTURBANCES RESTLESSNESS DIZZINESS JOINT PAIN

  28. MUS

  29. Kunsthistorischesmuseen Wien

  30. play a major role high prevalence a large number common on average 13% 10-20% 20-50% appr. 20% 20-50% appr. one-quarter to one-half at least one third one third 25-75% PREVALENCE OF MUSaccording to the MUS literature

  31. WHAT IS THE ALTERNATIVE? THE SYMPTOM DIAGNOSIS

  32. 1987

  33. BUT NOT EVERYONE AGREED…..

  34. ‘I find it personally objectionable to ask the patient why he has come to see me, and then diagnose his problem in the form of a symptom diagnosis. I have not spent most of my adult life in medicine to be diminished in this way. I can diagnose any symptom or complaint of my patients with a proper disease label’.

  35. A symptom diagnosis is not a diagnosis-without-a-meaning, on the contrary…. …what is truly meaningless is…

  36. the idea that, e.g., heart burn as a symptom diagnosis is better defined when called ‘medically unexplained’ heart burn • that things get better when this diagnosis is, subsequently, lumped into a category that includes all types of very heterogeneous other symptom diagnoses

  37. IT IS MUS…..

  38. ADVANTAGES OF USING THE • SYMPTOM DIAGNOSIS: • For direct patient care: it is based on the patient’s RFE, and documenting it as such prevents patients from being labelled with an uncertain diagnosis that might lead to unnecessary concern and inappropriate interventions. • 2.For epidemiology: it prevents the FD from ‘forcing’ a disease diagnosis into a box, even if it does not fit, thus keeping the disease rubrics ‘clean’.

  39. FINALLY….

  40. SOMETHING ELSE IS WRONG WITH MUS • The term implies that all symptoms are, or should be medically explainable, which is definitely untrue, and really quite an arrogant and very doctor-centered point of view • In fact: most symptoms are medically unexplained

  41. FOR EXAMPLE: • The case of thirst/diabetes • The case of headache/sinusitis • The case of weight change/depression • The case of heartburn/gastric ulcer

  42. Patients feel what they feel, in and out of the medical model….. ….it is not their fault that their symptoms do not fit the medical model

  43. THERE IS MORE TO LIFE THAN MEDICINE MAY DIAGNOSE

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