Symptoms: in the Head or in the Brain?

Editorials1 May 2001Symptoms: in the Head or in the Brain?Anthony L. Komaroff, MDAnthony L. Komaroff, MDDr. Komaroff: Harvard Medical School; Boston, MA 02115Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-9_Part_1-200105010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Symptoms are a regular part of the human experience. A survey of more than 1 million persons found that 40% to 55% were experiencing headaches, 33% to 46% fatigue, and 15% sore throat at the moment they were being surveyed (1). Typically, the participants described these symptoms as being of only "slight" severity.Sometimes a patient perceives a symptom as bothersome enough to constitute an "illness." Dingle prospectively followed 443 persons for 10 years, for a total of 970 036 person-days. There were 9.4 instances per person-year in which the participants reported symptoms that caused impairment sufficiently severe to be ...References1. Hammond EC. Some preliminary findings on physical complaints from a prospective study of 1,064,004 men and women. Am J Public Health. 1964;54:11-23. CrossrefGoogle Scholar2. Dingle JH. The ills of man. Sci Am. 1973;229:76-84. [PMID: 4731807] CrossrefMedlineGoogle Scholar3. Woodwell DA. National Ambulatory Care Medical Survey: 1998 Summary. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention; 2000. Google Scholar4. National Center for Health Statistics. Current Estimates from the Health Interview Survey. United States, 1977. Washington, DC: U.S. Government Printing Office; 1978. Google Scholar5. Aronowitz RA. When do symptoms become a disease? Ann Intern Med. 2001;134:803-8. LinkGoogle Scholar6. Sharpe M, Carson A. "Unexplained" somatic symptoms, functional syndromes, and somatization: do we need a paradigm shift? Ann Intern Med. 2001;134:926-30. LinkGoogle Scholar7. Kroenke K, Mangelsdorff AD. Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome. Am J Med. 1989;86:262-6. [PMID: 2919607] CrossrefMedlineGoogle Scholar8. Kroenke K. Studying symptoms: sampling and measurement issues. Ann Intern Med. 2001;134:844-53. LinkGoogle Scholar9. Kroenke K, Arrington ME, Mangelsdorff AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med. 1990;150:1685-9. [PMID: 2383163] CrossrefMedlineGoogle Scholar10. Jackson JL, Kroenke K. The effect of unmet expectations among adults presenting with physical symptoms. Ann Intern Med. 2001;134:889-97. LinkGoogle Scholar11. Hahn SR. Physical symptoms and physician-experienced difficulty in the physician–patient relationship. Ann Intern Med. 2001;134:897-904. LinkGoogle Scholar12. Barsky AJ. Palpitations, arrhythmias, and awareness of cardiac activity. Ann Intern Med. 2001;134:832-7. LinkGoogle Scholar13. Katon W, Sullivan M, Walker E. Medical symptoms without identified pathology: relationship to psychiatric disorders, childhood and adult trauma, and personality traits. Ann Intern Med. 2001;134:917-25. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Anthony L. Komaroff, MDAffiliations: Dr. Komaroff: Harvard Medical School; Boston, MA 02115Corresponding Author: Anthony L. Komaroff, MD, Harvard Health Publications, Countway Library of Medicine, Suite 602, 10 Shattuck Street, Boston, MA 02115. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLocal perceptions of causes of death in rural South Africa: a comparison of perceived and verbal autopsy causes of deathStudying Help-Seeking for Symptoms: The Challenges of Methods and ModelsThe Utility of Screening in the Design of Trials for Symptom Management in CancerDifferential Symptom Reporting by Mode of Administration of the AssessmentSymptom distress in advanced cancer patients with anxiety and depression in the palliative care settingPerceived PoisonsMedically Unexplained Physical SymptomsPhysical symptom profiles of depressed and nondepressed patients with cancerNew insights into culture driven disordersLa fibromyalgie : une affection psychosomatique ?Depression and anxiety 1 May 2001Volume 134, Issue 9_Part_1Page: 783-785KeywordsAnxietyBrainEmotionsFatigueNervous systemPatientsPerceptionPharyngitisSexual dysfunctionUpper respiratory tract infections ePublished: 1 May 2001 Issue Published: 1 May 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...