Somatic Symptoms Deserve Our Attention

Abstract

This commentary focuses on two articles in this issue which provide important insights regarding the diagnosis and management of medically unexplained symptoms (MUS). Up to half of all outpatient visits are prompted by a physical/somatic complaint of which at least a third are MUS. Analyzing data from the National Ambulatory Care Medical Survey, Gates, Petterson, Wingrove, Miller, and Klink (2016) confirmed the common finding that depression and anxiety in patients presenting with somatic symptoms are underrecognized. Only 1–4% of such patients received a diagnosis of depression or anxiety, a rate that should have been at least four- to sixfold greater. optimize the care of chronic somatic symptoms. In the second article, Clarke draws upon clinical experience spanning several decades and thousands of patients to delineates a pragmatic approach to managing MUS. His six-step strategy augmented by illustrative cases makes more tangible the process of caring for patients with chronic symptoms.