Health and illness lecture 1 term 2 – sociology of medically unexplained symptoms.
Into.
Illnesses without a diagnoses / disease.
Links to last term – biomed / social model, bedside medicine etc…
o Bridge between biomedical model (perspective looking at the physical body)
and patients experience with illness narratives (later in this lecture / next
week).
Links to ‘the disappearing patient’ last term reading.
Sociological contribution to unexplained illness – historically how patients can have
symptoms which are unexplained.
Can explore patients experiences of living with medically unexplained illness – how it
affects their self-identity
Studying doctor’s responses to patients with unexplained illness
And touches on the relationship with patient and doctor
What are medically unexplained symptoms?
When a patient presents to a doctor a set of symptoms, exhaustion, pain, limited
ability, intermittent symptoms – investigate, and cannot find symptom. Ill, but
unexplained.
Related labels: functional syndromes / symptoms (see slide)
Patients that are difficult for docs to deal with. No organic basis can be found to
make sense of the illness
Links to hypochondria
Group of symptoms = medically unexplained syndromes
o E.G. chronic fatigue syndrome in neurology (see slide for more)
o IBS
o Symptom based labels, no organic base
o Difficult to diagnose, some people accept legitimacy of these, some don’t
Prevalence
Studies that indicate a large proportion of patients that go through the healthcare
system have symptoms that are unexplained
o Particularly in neurology, cardiology, gynaecology, more.
o Neurology estimated 30% MUS (Carson et al 2000)
o 50-70% of symptoms in primary care (Kroenke and manglesdorrff, 1989)
How do physical symptoms come to be ‘unexplained’?
How did we achieve this separation of illness/ symptoms from disease? No bio
explanation.
o Place illness, disease, etc in historical context (last term) – Jewson, 2976,
bedside medicine – medical knowledge is produced through interaction of
docs and patients, disease and classification are defined by a set of
symptoms.
o Hospital / lab medicine – symptoms les important, what patients reported
were less important, but there was a focus on what could be seen in the body
Into.
Illnesses without a diagnoses / disease.
Links to last term – biomed / social model, bedside medicine etc…
o Bridge between biomedical model (perspective looking at the physical body)
and patients experience with illness narratives (later in this lecture / next
week).
Links to ‘the disappearing patient’ last term reading.
Sociological contribution to unexplained illness – historically how patients can have
symptoms which are unexplained.
Can explore patients experiences of living with medically unexplained illness – how it
affects their self-identity
Studying doctor’s responses to patients with unexplained illness
And touches on the relationship with patient and doctor
What are medically unexplained symptoms?
When a patient presents to a doctor a set of symptoms, exhaustion, pain, limited
ability, intermittent symptoms – investigate, and cannot find symptom. Ill, but
unexplained.
Related labels: functional syndromes / symptoms (see slide)
Patients that are difficult for docs to deal with. No organic basis can be found to
make sense of the illness
Links to hypochondria
Group of symptoms = medically unexplained syndromes
o E.G. chronic fatigue syndrome in neurology (see slide for more)
o IBS
o Symptom based labels, no organic base
o Difficult to diagnose, some people accept legitimacy of these, some don’t
Prevalence
Studies that indicate a large proportion of patients that go through the healthcare
system have symptoms that are unexplained
o Particularly in neurology, cardiology, gynaecology, more.
o Neurology estimated 30% MUS (Carson et al 2000)
o 50-70% of symptoms in primary care (Kroenke and manglesdorrff, 1989)
How do physical symptoms come to be ‘unexplained’?
How did we achieve this separation of illness/ symptoms from disease? No bio
explanation.
o Place illness, disease, etc in historical context (last term) – Jewson, 2976,
bedside medicine – medical knowledge is produced through interaction of
docs and patients, disease and classification are defined by a set of
symptoms.
o Hospital / lab medicine – symptoms les important, what patients reported
were less important, but there was a focus on what could be seen in the body
