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Occupational factors and unexplained physical symptoms

Published online by Cambridge University Press:  02 January 2018

Matthew Hotopf
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Liaison psychiatrists are frequently asked to see people with chronic, debilitating and unexplained physical symptoms, in particular chronic pain and chronic fatigue. People with these conditions have often seen many doctors and received multiple medical investigations, but rarely have had any effective treatment or even explanation for their symptoms. There are many reasons for focusing on occupational factors in this patient group. First, many people may attribute their symptoms to workplace exposures. For example, back pain may commonly be put down to accidents; upper limb disorders to use of keyboards or repetitive manual tasks; and headaches and fatigue to visual display units or air conditioning. These attributions have prognostic and legal implications, and are likely to affect the course of treatment. Second, for those who have had prolonged sickness absence, it is often necessary to make decisions regarding return to work or to help them negotiate the often lengthy and complex medical retirement process. This may be a major stumbling block in managing such people. Finally, psychiatrists are frequently invited to write medico-legal reports regarding the role of occupational factors in causing unexplained physical symptoms. This article aims to address these issues and provide some practical guidance to clinicians.

Type
Research Article
Information
Advances in Psychiatric Treatment , Volume 4 , Issue 3 , May 1998 , pp. 151 - 158
Copyright
Copyright © The Royal College of Psychiatrists 1998 

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