Treatment of somatization in primary care

A large proportion of patients present to primary care with chronic, stress-related symptoms having no organic cause. Biomedical treatment of these patients is usually ineffective and expensive. A 6-week behavioral medicine intervention designed to provide adjunctive treatment to primary care was ev...

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Bibliographic Details
Published in:General hospital psychiatry 1997-07, Vol.19 (4), p.251-258
Main Authors: McLeod, Caroline C., Budd, Matthew A., McClelland, David C.
Format: Article
Language:English
Subjects:
Adult
Affect
Analysis of Variance
Anxiety - therapy
Behavior Therapy - methods
Behavior therapy. Cognitive therapy
Behavioral Medicine - methods
Biological and medical sciences
Depression - therapy
Family Practice - methods
Female
Follow-Up Studies
Humans
Male
Medical sciences
Patient Acceptance of Health Care
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychophysiologic Disorders - diagnosis
Psychophysiologic Disorders - psychology
Psychophysiologic Disorders - therapy
Treatment Outcome
Treatments
Waiting Lists
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Summary:A large proportion of patients present to primary care with chronic, stress-related symptoms having no organic cause. Biomedical treatment of these patients is usually ineffective and expensive. A 6-week behavioral medicine intervention designed to provide adjunctive treatment to primary care was evaluated in a randomized, controlled study. Thirty-eight individuals receiving treatment and 44 waiting for treatment completed the SCL-90-R at times corresponding to 1 week before (time 1) and 1 week after the course (time 2). The treatment group was then followed up at 6 months. After correction for initial levels, the treatment group reported significantly less somatization, anxiety, and depression than did the wait-list group at time 2. Within the treatment group, decreases in somatization, anxiety, and depression were statistically significant and were maintained 6 months later. Within the wait-list group, distress remained unchanged. A review of relevant literature reveals that a general behavioral medicine course such as the one studied here has an important adjunctive role in primary care, since 1) subsyndromal psychological distress is common in primary care; 2) physicians are reluctant to address psychosocial issues; 3) negative mood is associated with poor health; 4) negative mood is associated with high, inappropriate medical utilization; and 5) negative mood is associated with help-seeking behavior.
ISSN:0163-8343
1873-7714
DOI:10.1016/S0163-8343(97)00047-9