Medically unexplained symptoms in patients referred to a specialist rheumatology service: prevalence and associations

Objectives. To determine the prevalence of medically unexplained rheumatic symptoms amongst patients newly referred to a rheumatology out‐patient service and to examine their relationship with pain, disability, socioeconomic factors and the presence of emotional disorders (anxiety, depression and panic). Methods. A sample of newly referred consecutive patients to a hospital‐based, regional rheumatology service was administered a questionnaire for assessment of emotional disorders, pain, health status and socioeconomic factors. Rheumatologists rated the degree to which patients' symptoms were explained by organic disease (organicity rating). Results. Two hundred and fifty‐six patients were eligible and 203 (79%) participated. The sample included 69% females and mean age was 50 yr. Ninety‐three (46%) had symptoms that were completely explained, 52 (26%) largely explained, 41 (20%) somewhat explained and 17 (8%) not at all explained by organic disease. Patients whose symptoms were of ‘low organicity’ (somewhat or not at all explained) were more likely to be female [relative risk (RR) 1.8, 95% confidence interval (CI) 1.0–3.1], younger (mean age 44 vs 52 yr, P