Medically unexplained physical symptoms

[6] The plethora of terms reflects imprecision and uncertainty in their definition, controversy, and care taken to avoid stigmatising affected people.

[9][10] Childhood adversity and/or abuse, and the death or serious illness of a close family member are significant risk factors.

[12][13] However, anxiety and depression are also very common in individuals with medically explained illnesses, and again, the likelihood of a person receiving one of these diagnoses increases with the number of symptoms reported.

[14][15] Physical symptoms have been associated with adverse psychosocial and functional outcome across different cultures, irrespective of etiology (either explained or unexplained).

[20] The most effective current treatment for some medically unexplained symptoms is a combination of therapeutic approaches tailored to the individual patient.

[21] The next best documented approach is cognitive behavioral therapy (CBT), with evidence from multiple randomized controlled trials.

[25] Overall, CBT has been shown to be effective in reducing psychological distress and improving medical status in MUPS patients.

One exception is menopausal syndrome, where SSRIs are "possibly effective" as well as a third class of antidepressants, the serotonin-norepinephrine reuptake inhibitors (SNRIs).

[25] A 2010 Cochrane review examined the use of Consultation Letters for MUPS with psychiatrist and found some evidence of their effectiveness in terms of medical cost and patient physical functioning.

[28] The studies reviewed were small and of moderate quality and completed primarily in the United States so generalizing results to other settings should be done with caution.

[29] [30] More contemporary theories place less emphasis on trauma and suggest that an individual's personality and psychological characteristics play a central role.