Primary care consultations about medically unexplained symptoms: How do patients indicate what they want?

Journal of General Internal Medicine

Volumn 24, Issue 4, 2009, Pages 450-456

  Salmon, Peter ^a   Ring, Adele ^a   Humphris, Gerry M ^b   Davies, John C ^a   Dowrick, Christopher F ^a  

^a UNIVERSITY OF LIVERPOOL   (United Kingdom)

^b UNIVERSITY OF ST ANDREWS   (United Kingdom)

Author keywords

Medically unexplained symptoms (MUS); Primary care consultation; Psychological needs

Indexed keywords

ADOLESCENT; ADULT; AGED; ARTICLE; DOCTOR PATIENT RELATION; FEMALE; HUMAN; INTERPERSONAL COMMUNICATION; MALE; METHODOLOGY; MIDDLE AGED; PATIENT; PRIMARY HEALTH CARE; PROSPECTIVE STUDY; PSYCHOLOGICAL ASPECT;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; COMMUNICATION; FEMALE; HUMANS; MALE; MIDDLE AGED; PATIENTS; PHYSICIAN-PATIENT RELATIONS; PRIMARY HEALTH CARE; PROSPECTIVE STUDIES;

EID: 67649961405     PISSN: 08848734     EISSN: 15251497     Source Type: Journal    
DOI: 10.1007/s11606-008-0898-0     Document Type: Article

References (42)

1. Peveler R, Kilkenny L, Kinmonth AL. Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion. J Psychosom Res. 1997;42:245-52. (Pubitemid 27186876)
2. van der Weijden T, van Velsen M, Dinant GJ, van Hasselt CM, Grol R. Unexplained complaints in general practice: prevalence, patients' expectations, and professionals' test-ordering behavior. Med Decis Making. 2003;23:226-31. (Pubitemid 36618063)
3. Ring A, Dowrick CF, Humphris GM, Davies J, Salmon P. The somatising effect of clinical consultation: What patients and doctors say and do not say when patients present medically unexplained physical symptoms. Soc Sci Med. 2005;61:1505-15. (Pubitemid 40991274)
4. Arnold IA, Speckens AE, van Hemert AM. Medically unexplained physical symptoms: the feasibility of group cognitive-behavioural therapy in primary care. J Psychosom Res. 2004;57:517-20. (Pubitemid 39642889)
5. Lamberg L. New mind/body tactics target medically unexplained physical symptoms and fears. J Am Med Assoc. 2005;294:2152-4. (Pubitemid 41571124)
6. Smith GR Jr, Monson RA, Ray DC. Patients with multiple unexplained symptoms. Their characteristics, functional health, and health care utilization. Arch Intern Med. 1986;146:69-72. (Pubitemid 16158631)
7. Stanley IM, Peters S, Salmon P. A primary care perspective on prevailing assumptions about persistent medically unexplained physical symptoms. Int J Psychiatry Med. 2002;32:125-40.
8. Garcia-Campayo J, Sanz-Carrillo C, Yoldi-Elcid A, Lopez-Aylon R, Monton C. Management of somatisers in primary care: are family doctors motivated? Aust N Z J Psychiatry. 1998;32:528-33. (Pubitemid 28393515)
9. Hahn SR, Thompson KS, Wills TA, Stern V, Budner NS. The difficult doctor-patient relationship: somatization, personality and psychopathology. J Clin Epidemiol. 1994;47:647-57. (Pubitemid 24171231)
10. Hartz AJ, Noyes R, Bentler SE, Damiano PC, Willard JC, Momany ET. Unexplained symptoms in primary care: perspectives of doctors and patients. Gen Hosp Psychiatry. 2000;22:144-52. (Pubitemid 30394708)
11. Wileman L, May C, Chew-Graham CA. Medically unexplained symptoms and the problem of power in the primary care consultation: a qualitative study. Fam Pract. 2002;19:178-82. (Pubitemid 34257780)
12. Zantinge EM, Verhaak PFM, Kerssens JJ, Bensing JM. The workload of GPs: consultations of patients with psychological and somatic problems compared. Br J Gen Pract. 2005;55:609-14. (Pubitemid 41149829)
13. Barsky AJ, Ettner SL, Horsky J, Bates DW. Resource utilization of patients with hypochondriacal health anxiety and somatization. Med Care. 2001;39:705-15. (Pubitemid 33610095)
14. Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry. 2005;62:903-10. (Pubitemid 41126885)
15. Kroenke K, Mangelsdorff AD. Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome. Am J Med. 1989;86:262-6. (Pubitemid 19081465)
16. Goldberg DP, Bridges K. Somatic presentations of psychiatric illness in primary care setting. J Psychosom Res. 1988;32:137-44.
17. Morriss RK, Gask L. Treatment of patients with somatized mental disorder: effects of reattribution training on outcomes under the direct control of the family doctor. Psychosom. 2002;43:394-9.
18. Salmon P, Ring A, Dowrick CF, Humphris GM. What do general practice patients want when they present medically unexplained symptoms, and why do their doctors feel pressurized? J Psychosom Res. 2005;59:255-60.
19. Peters S, Stanley I, Rose M, Salmon P. Patients with medically unexplained symptoms: Sources of patients' authority and implications for demands on medical care. Soc Sci Med. 1998;46:559-65. (Pubitemid 28024895)
20. Kirmayer LJ, Robbins JM. Patients who somatize in primary care: a longitudinal study of cognitive and social characteristics. Psychol Med. 1996;26:937-51. (Pubitemid 26305995)
21. Kirmayer LJ, Robbins JM. Three forms of somatization in primary care: prevalence, co-occurrence, and sociodemographic characteristics. J Nerv Ment Dis. 1991;179:647-55.
22. Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. J Am Med Assoc. 2000;284:1021-7. (Pubitemid 30659134)
23. Kappen T, van Dulmen S. General practitioners' responses to the initial presentation of medically unexplained symptoms: a quantitative analysis. Biopsychosoc Med. 2008;2:22.
24. Valori R, Woloshynowych M, Bellenger N, Aluvihare V, Salmon P. The patient requests form: A way of measuring what patients want from their general practitioner. J Psychosom Res. 1996;40:87-94. (Pubitemid 26059542)
25. Salmon P, Dowrick CF, Ring A, Humphris GM. Voiced but unheard agendas: qualitative analysis of the psychosocial cues that patients with unexplained symptoms present to general practitioners. Br J Gen Pract. 2004;54:171-6. (Pubitemid 38279486)
26. Dowrick CF, Ring A, Humphris GM, Salmon P. Normalisation of unexplained symptoms by general practitioners: a functional typology. Br J Gen Pract. 2004;54:165-70. (Pubitemid 38279485)
27. Ring A, Dowrick C, Humphris G, Salmon P. Do patients with unexplained physical symptoms pressurise general practitioners for somatic treatment? A qualitative study. Br Med J. 2004;328:1057-60. (Pubitemid 38580831)
28. Salmon P, Quine J. Patients' requests in primary care: measurement and preliminary investigation. Psychol Health. 1989;3:103-10.
29. DelVecchio Good MJ, Good BJ, Nassi AJ. Patient requests in primary health care settings: Development and validation of a research instrument. J Behav Med. 1983;6:151-68. (Pubitemid 13024883)
30. Raudenbush S, Bryk A. Hierarchical Linear Models: Applications and Data Analysis Methods. 2Thousand Oaks: Sage; 2002.
31. Salmon P. The potentially somatizing effect of clinical consultation. CNS Spectr. 2006;11:190-200.
32. Salmon P, Humphris GM, Ring A, Davies JC, Dowrick CF. Why do primary care physicians propose medical care to patients with medically unexplained symptoms? A new method of sequence analysis to test theories of patient pressure. Psychosom Med. 2006;68:570-7. (Pubitemid 44297653)
33. Escobar JI, Gara M, Silver RC, Waitzkin H, Holman A, Compton W. Somatisation disorder in primary care. Br J Psychiatry. 1998;173:262-6. (Pubitemid 28407461)
34. Zaballa P, Crega Y, Grandes G, Peralta C. The Othmer and DeSouza test for screening of somatisation disorder: is it useful in general practice? Br J Gen Pract. 2001;51:182-6. (Pubitemid 32197359)
35. Schilte AF, Portegijs PJ, Blankenstein AH, Knottnerus JA. Somatisation in primary care: clinical judgement and standardised measurement compared. Soc Psychiatry Psychiatr Epidemiol. 2000;35:276-82. (Pubitemid 30441267)
36. Leiknes KA, Finset A, Moum T, Sandanger I. Methodological issues concerning lifetime medically unexplained and medically explained symptoms of the Composite International Diagnostic Interview: a prospective 11-year follow-up study. J Psychosom Res. 2006;61:169-79. (Pubitemid 44118356)
37. Salmon P, Peters S, Clifford R, et al. Why do general practitioners decline training to improve management of medically unexplained symptoms? J Gen Intern Med. 2007;22:565-71. (Pubitemid 46941183)
38. Epstein RM, Shields CG, Meldrum SC, et al. Physicians' responses to patients' medically unexplained symptoms. Psychosom Med. 2006;68:269-76. (Pubitemid 43740131)
39. Rief W, Martin A, Rauh E, Zech T, Bender A. Evaluation of general practitioners' training: How to manage patients with unexplained physical symptoms. Psychosom. 2006;47:304-11.
40. Morriss R, Dowrick C, Salmon P, et al. Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms. Br J Psychiatry. 2007;191:536-42. (Pubitemid 350273215)
41. Rosendal M, Olesen F, Fink P, Toft T, Sokolowski I, Bro F. A randomized controlled trial of brief training in the assessment and treatment of somatization in primary care: effects on patient outcome. Gen Hosp Psychiatry. 2007;29:364-73. (Pubitemid 46962691)
42. Salmon P, Humphris GM, Ring A, Davies JC, Dowrick CF. Primary care consultations about medically unexplained symptoms: patient presentations and doctor responses that influence the probability of somatic intervention. Psychosom Med. 2007;69:571-7. (Pubitemid 47205742)