How do you approach the management of patients with persistent, unexplained symptoms (e.g., fatigue, pain, dizziness) when diagnostic workup is negative?

What do you include in your approach to patients with persistent, unexplained symptoms (e.g., fatigue, pain, dizziness) when diagnostic workup is negative?

• Frequent follow-up office visits
• Screening for depression, social isolation
• Repeat initial history and focused physical exam
• Focus of symptom validation
• Optimize sleep hygiene
• Referral to cognitive behavioral therapy
• Recommend mindfulness interventions
• Other