Zoek in de site...

The power of words: examining the occurrence and effects of language in general practice consultations for patients presenting medically unexplained symptoms


Time frame

September 2017 - November 2022

Project description

Can language help to solve communication challenges in consultations with patients presenting medically unexplained symptoms (MUS)? These symptoms are serious and not well understood. Although scholars have repeatedly ascertained the importance of doctor-patient interactions for establishing and handling MUS, previous research failed to involve a linguistic account of communication.

This research assessed language and interaction in naturally occurring consultations about medically unexplained (versus explained) symptoms in order to uncover communication patterns and their consequences. Previous research that analysed clinical interactions about medically unexplained symptoms (MUS) mostly focused on the content of communication, i.e. what is talked about. Though physicians agree that the words they use are a key factor during consultations, few studies have examined how general practitioners (GPs) and patients with MUS communicate. This research aimed to fill this gap using research from two different perspectives. The first aim was to examine language use and interactional aspects in consultations about MUS using a qualitative approach, namely conversation analysis (CA). The second aim was to compare how language use differs in consultations about MUS compared with consultations about medically explained symptoms (MES). A newly developed quantitative coding protocol was used for this.


Stortenbeker, I.A., Olde Hartman, T.C., Kwerreveld, A., Stommel, W.J.P., Dulmen, A.M. van & Das, E. (2022). Unexplained versus explained symptoms: The difference is not in patients' language use. A quantitative analysis of linguistic markers. Journal of Psychosomatic Research, 152:110667. doi: 10.1016/j.jpsychores.2021.110667

Stortenbeker, I.A., Salm, L.P., Olde Hartman, T.C., Stommel, W.J.P., Das, E. & Dulmen, S. van (2022). Coding linguistic elements in clinical interactions: a step-by-step guide for analyzing communication form. BMC Medical Research Methodology, 22 (1):191. doi: 10.1186/s12874-022-01647-0

Stortenbeker, I., Stommel, W., olde Hartman, T., van Dulmen, S., & Das, E. (2021). How general practitioners raise psychosocial concerns as a potential cause of medically unexplained symptoms: A conversation analysis. Health Communication, Ahead-of-print, 1-12.

Stortenbeker, I., Stommel, W., van Dulmen, S., Lucassen, P., Das, E., & olde Hartman, T. (2020). Linguistic and interactional aspects that characterize consultations about medically unexplained symptoms: A systematic review. Journal of psychosomatic research, 132 (109994).

Stortenbeker, I., Houwen, J., Dulmen, S. van, Olde Hartman, T. & Das, E. (2019). Quantifying implicit uncertainty in primary care consultations. A systematic comparison of communication about medically explained versus unexplained symptoms. Patient Education and Counseling, 102 (12), 2349-2352.

Stortenbeker, I., Houwen, J., Lucassen, P. L., Stappers, H., Assendelft, W., van Dulmen, S., ... & Das, E. (2018). Quantifying positive communication: doctor’s language and patient anxiety in primary care consultations. Patient education and counseling, 101 (9), 1577-1584.




  • Radboudumc, Nijmegen
  • Nivel


Inge Stortenbeker, inge.stortenbeker@ru.nl