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Titolo:
Somatization reconsidered - Incorporating the patient's experience of illness
Autore:
Epstein, RM; Quill, TE; McWhinney, IR;
Indirizzi:
Univ Rochester, Sch Med & Dent, Highland Hosp, Dept Family Med,Primary Care Univ Rochester Rochester NY USA 14620 Hosp, Dept Family Med,Primary Care Univ Rochester, Sch Med & Dent, Program Biopsychosocial Studies, Rochester, Univ Rochester Rochester NY USA 14620 Biopsychosocial Studies, Rochester, Univ Rochester, Sch Med & Dent, Dept Internal Med, Rochester, NY 14620 USAUniv Rochester Rochester NY USA 14620 ternal Med, Rochester, NY 14620 USA Univ Rochester, Sch Med & Dent, Dept Psychiat, Rochester, NY 14620 USA Univ Rochester Rochester NY USA 14620 t Psychiat, Rochester, NY 14620 USA Genesee Hosp, Dept Med, Rochester, NY 14607 USA Genesee Hosp Rochester NYUSA 14607 sp, Dept Med, Rochester, NY 14607 USA Inst Estudis Salut, Barcelona, Spain Inst Estudis Salut Barcelona SpainInst Estudis Salut, Barcelona, Spain Univ Western Ontario, Ctr Studies Family Med, London, ON, Canada Univ Western Ontario London ON Canada ies Family Med, London, ON, Canada
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 3, volume: 159, anno: 1999,
pagine: 215 - 222
SICI:
0003-9926(19990208)159:3<215:SR-ITP>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
IRRITABLE-BOWEL-SYNDROME; LOW-BACK-PAIN; PRIMARY-CARE; PSYCHIATRIC-CONSULTATION; MEDICAL-CARE; SYMPTOMS; PREVALENCE; DEPRESSION; COMMUNITY; DISORDERS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
86
Recensione:
Indirizzi per estratti:
Indirizzo: Epstein, RM Univ Rochester, Sch Med & Dent, Highland Hosp, Dept Family Med,Primary Care Univ Rochester 885 South Ave Rochester NY USA 14620 imary Care
Citazione:
R.M. Epstein et al., "Somatization reconsidered - Incorporating the patient's experience of illness", ARCH IN MED, 159(3), 1999, pp. 215-222

Abstract

The large and heterogeneous group of patients with "unexplained somatic symptoms," with or without coexisting psychiatric, "functional," or "organic"illnesses, provides continuing difficulty for clinicians. The construct ofsomatization artificially separates bodily and psychological symptoms thatpatients experience as a unified whole. Concurrent chronic illnesses make it difficult to exclude "general medical conditions. " The diagnosis requires that the patient seek medical care. Conflict between patients' experiences of illness and physicians' diagnostic categories, and fear of blaming thepatient, complicate naming and characterizing the illness. We recommend anapproach to clinical care that involves exploring the patient's life context, finding mutually meaningful language to arrive at a name for the illness, normalizing the patient's bodily experience of distress, using a chronicdisease model that attends to functioning, and addressing the physician's need for certainty and efficacy. Health systems can help coordinate care and avoid iatrogenic harm by appropriately controlling access to medical services.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/04/20 alle ore 01:39:52