Somatisation and alexithymia in patients with high use of medical care and medically unexplained symptoms
Source: Mental Health in Family Medicine, Volume 5, Number 3, September 2008 , pp. 139-148(10)
Publisher: Radcliffe Publishing Ltd.
Abstract:Background and objective: Few reports in the medical literature examine physician agreement on a standard assessment for somatisation in primary care patients. We describe somatising patients who were subjectively identified by family physicians and subsequently classified on the somatisation spectrum by a standard evaluation. We also examine the relation between somatisation and alexithymia.
Method: Responding to a brief verbal prompt, family physicians referred high-utilising patients 18 years old and older who had 'persistent medically unexplained symptoms for at least 6 months' (n = 72). Patients who agreed to participate in the study (n = 48) were assessed individually using a structured diagnostic interview and two measures of alexithymia.
Results: All participating patients met inclusion criteria for one of two abridged subtypes on the somatisation spectrum. Somatisation was not related to alexithymia.
Conclusions: Family physicians subjectively identified patients who had somatisation, with a high level of accuracy and without formal screening or diagnostic tests. Embedded in a disease-management system, especially an electronic version, a brief verbal prompt to physicians to identify patients on the somatisation spectrum could potentially realise considerable savings in physician time and medical system financial expenditures.
Document Type: Research Article
Affiliations: 1: Department of Family Medicine and Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA 2: Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA 3: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA 4: Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA 5: Department of Psychology, Fox Lake Correctional Institution, Fox Lake, Wisconsin, USA 6: Division of Biomedical Informatics and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
Publication date: 2008-09-01