The Joint Commissioning Panel for Mental Health has published: Guidance for commissioners of services for people with medically unexplained symptoms
The term Medically Unexplained Symptoms (MUS) refers to persistent bodily complaints for which adequate examination does not reveal sufficient explanatory structural or other specified pathology.
This guide aims to:
- describe MUS and the associated outcomes
- outline current service provision for MUS and detail the components of a high quality comprehensive MUS service, and
- highlight the importance of commissioning comprehensive MUS services.
The guidance gives a list of Functional Somatic Syndromes (aka MUS):
- Irritable Bowel Syndrome (Gastroenterology)
Bloating, constipation, loose stools, abdominal pain
- Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
(Infectious Diseases, Endocrinology, Rheumatology, Pain Clinics)
Fatigue (particularly post-exertional and long recovery) pain, sensitivity to smell
- Post Concussion Syndrome (Neurology)
Headache, vomiting, dizziness
- Chronic Pelvic Pain (Gynaecology)
Pelvic pain, painful sex, painful periods
- Fibromyalgia/Chronic Widespread Pain (Rheumatology)
Pain and tender points, fatigue
- Hyperventilation (Respiratory Medicine)
Chest pain, palpitations, shortness of breath
- Non-cardiac chest pain (Cardiology)
Shortness of breath
- Temporo-mandibular Joint Dysfunction (Dentist, Oral Medicine)
Jaw pain, teeth grinding
- Multiple Chemical Sensitivity (Allergy clinic)
Reaction to smells, light
The ME community challenges the classification of ME as medically unexplained:
carersfight blog post from Stonebird: Why ME must be removed from JCPMH
- ME is not a Functional Somatic Syndrome (FSS)
- Myalgic Encephalomyelitis (ME) is listed in the WHO International Classification of Diseases (ICD), chapter 6, under Disorders of Brain at ICD-10 G 93.3. It is not classified as a mental health disorder.
- Numerous clinicians and researchers have affirmed many underlying biological abnormalities in ME
- A “Functional Somatic” interpretation of ME creates a chicken and egg situation where you have to have the tests to prove you are ill, but the psychiatrists have denied you those tests , so you will not have the proof to prove you are ill. Read more
Margaret Williams: Absence Of Evidence
For decades, the proponents of the now-infamous PACE Trial — particularly Professors Simon Wessely and Peter White — have maintained that without hard evidence of organic pathology, they will not accept the WHO classification of ME/CS as an organic disorder and they insist that it is a functional somatic syndrome (FSS).
In other words, ignoring the existing evidence-base of pathoaetiology, since there is not as yet a definitive test for ME/CFS, they believe that absence of evidence really is evidence of absence, so they continue to categorise ME/CFS as a behavioural disorder that can be “cured” by cognitive behavioural therapy (CBT) and graded exercise therapy (GET) and they advise Departments of State that these interventions are both effective and cost-effective.
Read more about the lack of evidence of both clinical benefit and cost effectiveness of CBT and GET for ME/CFS