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The Conundrum of Medically Unexplained Symptoms: Questions to Consider

Received June 7, 2007; revised November 14, 2007; accepted December 4, 2007. From The Centre for Military and Veteran’s Health, The University of Adelaide, Australia; and The Centre for Military and Veteran’s Health, The University of Queensland, Australia. Send correspondence and reprint requests to Dr. Christopher Barton, Centre for Military and Veterans Health, School of Population Health and Clinical Practice, Faculty of Health Sciences, The University of Adelaide, South Australia 5005. e-mail: christopher.barton{at}adelaide.edu.au
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: The classification and etiology of medically unexplained symptoms remain a clinical challenge. Recent proposals to improve systems of classification include ending the tradition of separating symptoms into medical or psychiatric groups. METHOD: Several research questions are proposed to resolve some of the divergent opinions about the nature of these difficulties. CONCLUSION: Unitary models of somatic symptom causation should not be presumed. Examination of the causes and nature of somatic distress in those with and without psychiatric disorders requires separate investigation for each, and these should not be presumed to be similar. Psychophysiological models of somatic symptoms are required that can be studied in research protocols.

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