Guidance for health professionals on medically unexplained symptoms (MUS)
Despite having a strong suspicion that there is no serious medical problem, GPs worry about missing something serious and are often left with a sense of dissatisfaction with such cases. Patients may feel unsupported and confused. Such uncertainty often leads to extensive and unproductive investigations.
This guidance will highlight the importance of clinicians trusting, perhaps more than they do, their own psychological abilities and the strengths of their therapeutic alliance with their patients. This would help achieve better concordance between addressing the patients' fears and managing their own anxiety and uncertainty.
Primary Care Guidance: Treating depression in people with Coronary Heart Disease (CHD)
Depression affects about 20% of people with CHD and is linked to poor medical outcome. This fact sheet presents current knowledge about the links between CHD and depression, and best clinical practice.
Key learning points:
• Depression is a risk factor for CHD • Depression worsens cardiac prognosis • Case finding of depression in people with CHD is advocated by QoF • Co morbid depression is improved by medication and psychological treatments • Evidence for depression treatment improving cardiac outcomes is currently unavailable