Detection and diagnosis

Almost any symptom can occur in the absence of disease, but some, such as fatigue and subjective bloating, are more likely to be functional than others. Surprisingly, the more somatic symptoms a person has, the less likely it is that these symptoms reflect the presence of disease and the more likely there is associated depression and anxiety.

Knowledge Beliefs

Bodily perceptions

Cognitive interpretation -¡^flT^

Mental state

Symptoms Behavioural change Disability

Maintaining factors:

• Secondary physiological,

psychological, and

behavioural changes

• Iatrogenic factors

• Reactions to others

Interactive aetiology of "unexplained symptoms"

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