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The ‘unexplained’ illness: costly, but is it treatable?
  1. Jonathan M Silver
  1. Correspondence to Dr Jonathan M Silver, Department of Psychiatry, New York University School of Medicine, 40 East 83rd Street, Suite 1E, New York, NY 10028, USA; jonsilver{at}

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A wise senior clinician taught that ‘it's easier to know what to do than what it is.’ All physicians have patients with physical complaints that are puzzling and unexplained. Those with somatic symptoms such as headache, dizziness and fatigue may be referred to a neurologist for further evaluation. The paper by Carson et al (see page 810) investigates those neurology outpatients, referred from their primary care physicians, and documents the personal and social cost of those who have symptoms ‘unexplained by organic disease.’1

Neurologists rated a cohort of 3781 patients as to whether they considered …

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  • Provenance and peer review Commissioned; not externally peer reviewed.

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