Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

  • Log out

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
  • Log out
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Research ArticleOriginal Article

Understanding and Caring for the Distressed Patient With Multiple Medically Unexplained Symptoms

Edward A. Walker, Jürgen Unützer and Wayne J. Katon
The Journal of the American Board of Family Practice September 1998, 11 (5) 347-356; DOI: https://doi.org/10.3122/15572625-11-5-347
Edward A. Walker
From the Department of Psychiatry (EAW, JU, WJK), Division of Consultation-Liaison, University of Washington Medical School, Seattle.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jürgen Unützer
From the Department of Psychiatry (EAW, JU, WJK), Division of Consultation-Liaison, University of Washington Medical School, Seattle.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Wayne J. Katon
From the Department of Psychiatry (EAW, JU, WJK), Division of Consultation-Liaison, University of Washington Medical School, Seattle.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • References
  • Info & Metrics
  • PDF
Loading

Abstract

Background: Although physicians commonly encounter patients with complicated medical problems, some have a mix of unexplained medical symptoms and distress that can seem overwhelming to patient and physician alike.

Methods: We describe a model for thinking about and helping these complex patients. The model was developed from our personal clinical experience as primary care psychiatric consultants, as well as from a review of the literature using such key words as “difficult,” “frustrating,” and “somatization.”

Results: The model involves understanding predisposing factors that render the patient vulnerable to the development of a disabling condition, precipitating factors that initiate an episode of illness, and perpetuating factors that maintain maladaptive illness behaviors with time.

Conclusions: Awareness of these factors allows the clinician not only to tolerate and gradually unravel the complicated interactions that create and sustain distress in patients with multiple medically unexplained symptoms, but also devise practical and effective management strategies for these complex patients.

PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Practice: 11 (5)
The Journal of the American Board of Family Practice
Vol. 11, Issue 5
1 Sep 1998
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
  • Front Matter (PDF)
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Understanding and Caring for the Distressed Patient With Multiple Medically Unexplained Symptoms
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
2 + 12 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Understanding and Caring for the Distressed Patient With Multiple Medically Unexplained Symptoms
Edward A. Walker, Jürgen Unützer, Wayne J. Katon
The Journal of the American Board of Family Practice Sep 1998, 11 (5) 347-356; DOI: 10.3122/15572625-11-5-347

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Understanding and Caring for the Distressed Patient With Multiple Medically Unexplained Symptoms
Edward A. Walker, Jürgen Unützer, Wayne J. Katon
The Journal of the American Board of Family Practice Sep 1998, 11 (5) 347-356; DOI: 10.3122/15572625-11-5-347
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Medically unexplained symptoms: time to and triggers for diagnosis in primary care consultations
  • Google Scholar

More in this TOC Section

  • Screening for Dementia: Family Caregiver Questionnaires Reliably Predict Dementia
  • Help-Seeking for Insomnia among Adult Patients in Primary Care
  • How Much Time Do Patients with Diabetes Spend on Self-Care?
Show more Original Articles

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire