Background
Medically Unexplained Physical Symptoms (MUPS) captures conditions characterized by symptoms without corresponding objective findings, such as asthenia, low back pain, fibromyalgia, irritable bowel syndrome, or chronic fatigue syndrome. Drawing upon our clinical experience, we distinguish between everyday and self-limiting complaints as compared to persistent MUPS, with long-lasting symptom and loss of function.
Although the term is debated, we find its use appropriate for clinical and research purposes. First, there are substantial similarities and co-morbidity across different MUPS disorders, indicating possible common underlying symptom mechanisms. Second, several studies claim similar treatment to be effective across different MUPS disorders. Third, patients with MUPS have been associated with high costs, both direct (health care use) and indirect costs (productivity loss due to sickness absence).
The research literature on MUPS prevalence in general practice is conflicting, with prevalence rates ranging from 1.1 to 33%. This is probably due to different or imprecise definitions of the condition, or different data sources for measurement. An often-reported figure is 15%, while Steinbrecher et al. report more than two-thirds of all consultations to be related to MUPS. A recent Cochrane review calls for more knowledge about the use of social benefits among patient with MUPS. Consultation prevalence, or the proportion of consultations with a certain condition, is an adequate measure for health care utilization related to different health problems in general practice, for instance when estimating direct costs of MUPS.
Effective interventions for patients with persistent MUPS in general practice are yet to be established, but should be based on treatment studies where more descriptive knowledge of the patients is included. We therefore conducted a study in a naturalistic GP-setting to estimate the consultation prevalence and describe symptom pattern of patients with persistent MUPS in Norwegian general practice. We also wanted to describe these patients' employment status and use of social benefits, and the GPs management strategy.