Treatment of somatization in primary care

Author(s): Budd, M. A., McClelland, D. C.

Journal/Book: Gen Hosp Psychiat. 1997; 19: 655 Avenue of the Americas, New York, NY 10010. Elsevier Science Inc. 251-258.

Abstract: 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 of 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.

Note: Article McLeod CC, Hlth Care Partners, Bay Shores Med Grp, 19601 Mariner Ave, Torrance,CA 90503 USA

Keyword(s): PSYCHIATRIC-DISORDER; DEPRESSIVE SYMPTOMS; MEDICAL UTILIZATION; FAMILY-PRACTICE; PREVALENCE; THERAPY; PHYSICIANS; COMMUNITY; SERVICES; ANXIETY

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