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Techniques for Interviewing the Somatising Patient

Published online by Cambridge University Press:  02 January 2018

Francis Creed*
Affiliation:
Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Elspeth Guthrie
Affiliation:
Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
*
Correspondence

Abstract

Liaison psychiatrists need to interview somatising patients in a way which allows a full assessment of the problem. This can best be achieved if the psychiatrist has already discussed with the referring physician the reason for referral and what the patient has been told about it. The medical notes should always be reviewed in detail and independent data obtained from a relative or other informant. During the interview itself the psychiatrist must be prepared to use techniques which deepen rapport with the patient, who may be initially wary or hostile. The psychiatrist should attempt to establish early a treatment alliance. Special aspects of the mental state need to be noted, including the patient's attitude to his/her symptoms and the strength with which somatic beliefs are held. Different approaches may be used according to the nature of the problem and the therapeutic style of the doctor. An awareness of these interview techniques would greatly reduce the chances of fruitless interviews with a hostile patient who believes the symptoms are being dismissed as being ‘all in the mind’.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

Bass, C. & Murphy, M. (1990) The chronic somatizer and the Government White Paper. Journal of the Royal Society of Medicine, 83, 203205.CrossRefGoogle ScholarPubMed
Benjamin, S. (1989) Psychological treatment of chronic pain: a selective review. Journal of Psychosomatic Research, 33, 121131.Google Scholar
Bridges, K. & Goldberg, D.P. (1985) Somatic presentation of DSM–III psychiatric disorders in primary care. Journal of Psychosomatic Research, 29, 563569.Google Scholar
Feinmann, C., Harris, M. & Crawley, R. (1985) Psychogenic facial pain. British Medical Journal, 288, 436438.Google Scholar
Goldberg, D.P. & Bridges, K. (1988) Somatic presentation of psychiatric illness in primary care setting. Journal of Psychosomatic Research, 32, 137144.Google Scholar
Goldberg, D.P., Gask, L. & O'Dowd, T. (1989) The treatment of somatization: teaching techniques of reattribution. Journal of Psychosomatic Research, 33, 689695.Google Scholar
Guthrie, E.A. (1991) Brief psychotherapy with patients with refractory irritable bowel syndrome. British Journal of Psychotherapy Research, 8, 175188.Google Scholar
Katon, W., Ries, R. & Kleinman, A. (1984) A prospective DSM–III study of consecutive somatisation patients. Comprehensive Psychiatry, 25, 305314.Google Scholar
Sensky, T., Greer, S., Cundy, T., et al (1985) Referrals to psychiatrists in a general hospital – comparison of two methods of liaison psychiatry: preliminary communication. Journal of the Royal Society of Medicine, 78, 463468.Google Scholar
Thomas, C.J. (1983) Referrals to a British liaison psychiatry service. Health Trends, 15, 6164.Google Scholar
Wessely, S., David, A., Butler, S., et al (1989) The management of the chronic 7ldquo;post–viral” fatigue syndrome. Journal of the Royal College of General Practitioners, 39, 2629.Google Scholar
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