Review Medically Unexplained Symptoms: A Systematic Umbrella Review of Current Terminology and Reported Rationales 2026 Masters et al

[Andy]

Objectives:

This review addresses current naming conventions for Medically Unexplained Symptoms (MUS) through a systematic umbrella review. Terminology used and provided rationales were considered.

Methods:

Registered with PROSPERO (CRD42024526020), this review searched eight key databases, last on January 28, 2025. Reviews including medically unexplained symptoms (or synonym or subtype) in their systematic search terms were included (N=422).

Results:

A total of 577 references to 111 terms were made across the reviews, with numerous reviews using the same overarching terms, including “functional” (n=233), “somatic” (or variants thereof, n=51) and “medically unexplained” (n=28). Thirty percent of terms (n=179) were to specific syndromes or terms that did not group together under an overarching term, suggesting substantial variability in terms, even though over 60% of authors were primarily associated with just three disciplines – medicine, allied health, and psychology. A subset of 23 reviews provided rationales that underwent a content analysis and ROBIS risk-of-bias assessment. This analysis showed that rationales tended to (1) highlight differences between psychological, psychiatric and other medical fields (n=7), (2) focus on the patient perspective and patient-practitioner therapeutic relationship (n=10), or (3) follow broad and/or commonly used terms (n=7).

Discussion:

The current landscape of terminology used for MUS remains varied, nuanced, and inconsistent between disciplines. Moving forward to more universal language accepted and used by both patients and practitioners would aid in the diagnosis, management, and treatment of MUS.

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[Utsikt]

What about examining the validity of MUS first?

 

[rvallee]

Moving forward to more universal language accepted and used by both patients and practitioners would aid in the diagnosis, management, and treatment of MUS.

with numerous reviews using the same overarching terms, including “functional” (n=233)

This is not realistic with the current system. The current language was designed precisely to be maximally deceitful, to achieve dishonest ends through dishonest means, to seem palatable while not losing the meaning it has for clinicians, who clearly hear the dog whistles.

All of this is by design. Decades of careful, calculated design aimed at the current state of affairs, which is unacceptable to patients but beloved by health care systems, who will literally make a show of appearing acceptable, through deceit.

It's like designing a fair fiscal system. It's perfectly doable, even easy, but humans gonna human and pretend that obviously false assertions might be true, knowing plainly that they simply hide the real goals. Mostly because corruption. Humans are so easy and cheap to corrupt, for all sorts of reasons.

The purpose of a system is what it does. This is what systems built on the pretense of helping us have built for us, to better fool and neglect us. All on purpose. We'd have to fix what's wrong with humanity before. It's not as if there are any true "rationales" here, most of this is at best excuses.