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Paediatr Child Health. 2008 Jul;13(6):487-91.

Medically unexplained symptoms in young people: The doctor's dilemma.

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Departments of Psychiatry and Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario.


Medically unexplained symptoms in young people can present a challenge for primary care physicians to manage. Despite the prevalence of this clinical problem, physicians feel ill-equipped to deal with it. Families may attribute symptoms to an organic cause, despite the absence of identified pathology, and often resist considering psychosocial contributing factors. The present article outlines the key principles in the management of medically unexplained symptoms. Treatment focuses on building a therapeutic alliance with the patient and the family, the use of psychotherapeutic interventions and the role of psychopharmacology. A family-oriented rehabilitative approach to care, with a focus on functional improvement rather than symptom reduction, is emphasized.


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