Epidemiology and organisation of care in medically unexplained symptoms: A systematic review with a focus on cultural diversity and migrants

Peter Vermeir*, An Mariman, Lilla Lucza, Viola Sallay, Anne Weiland, Karen M. Stegers-Jager, Dirk Vogelaers

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


Background: Since the pathophysiology of medically unexplained symptoms (MUS) remains unclear, healthcare providers often struggle with these patients, especially with a different ethnic and/or cultural background. These challenges are insufficiently addressed in their training and in the organisation of care. Aim: To improve healthcare provider-patient interaction focused on MUS patients in general and in ethnic minorities and refugees in particular through a systematic review of syndromal definitions and epidemiology and organisation of care of MUS patients. Methods: Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords ‘Medical unexplained (physical) symptoms (MUPS)’, ‘Somatoform disorder’, ‘Functional syndrome’, ‘Diversity’, ‘Migrants’, ‘Ethnicity’, ‘Care models’, ‘Medical education’, ‘Communication skills’, ‘Health literacy’. Results: Different case definitions result in markedly different epidemiological estimates for MUS patients. Nevertheless, they are prevalent in a wide range of healthcare settings. Literature offers evidence of the effectiveness of structural frameworks in approaching MUS patients. Organisation of MUS care needs to transcend different levels of care: specialist tertiary and secondary care and primary care involving different qualifications of caregivers need to be aligned. Conclusion: The systematic review identified significant gaps and shortcomings in organisation of care. These need to be addressed in order to improve outcomes.

Original languageEnglish
Article numbere14855
JournalInternational Journal of Clinical Practice
Issue number12
Early online date13 Sept 2021
Publication statusPublished - Dec 2021

Bibliographical note

Funding Information:
The study was funded by the European Commission, Erasmus+ Strategic Partnership aimed at Medical Education on Medically Unexplained Symptoms and Intercultural Communication. /MUSIC/Nr 2018‐2021.2018‐1‐NL01_KA203‐038971.

Publisher Copyright:
© 2021 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd.


Dive into the research topics of 'Epidemiology and organisation of care in medically unexplained symptoms: A systematic review with a focus on cultural diversity and migrants'. Together they form a unique fingerprint.

Cite this