Review: Somatization, disease attribution and public health

Journal/Book: Z Klin Psychol Psychiatr Psyc. 1998; 46: Postfach 2540, W-4790 Paderborn, Germany. Verlag Ferdinand Schoningh. 193-214.

Abstract: Somatization, i.e. The presentation of somatic symptoms in the absence of somatic disease, is a frequent and significant problem for both medicine and public health. In the present review, findings pertaining to the frequency of bodily complaints in the general population, the frequency of medically unexplained symptoms and the presentation of somatic symptoms in patients with psychological disorders are presented. The cognitive appraisal of physical symptoms is suggested to be a central factor for the development of a somatoform disorder. With some newly described syndromes such as multiple chemical sensitivity, fibromyalgia and chronic fatigue syndrome, it seems that not so much the (non-specific) symptoms define the syndrome but rather the causal attributions held by the patients or doctors. Somatic symptom attributions may result in a type of illness behaviour which, in interaction with somatically oriented diagnostical and therapeutical strategies, leads to inadaequate utilisation of health care services. Implications for both the quality and costs of health care and possible intervention strategies are discussed.

Note: Review Faller H, Univ Wurzburg, Inst Psychotherapie & Med Psychol, Klin Str 3, D-97070 Wurzburg, GERMANY

Keyword(s): CHRONIC FATIGUE SYNDROME; IRRITABLE-BOWEL-SYNDROME; PRIMARY FIBROMYALGIA SYNDROME; MULTIPLE CHEMICAL-SENSITIVITY; ABNORMAL ILLNESS BEHAVIOR; DSM-III DIAGNOSES; NONULCER DYSPEPSIA; RHEUMATOID-ARTHRITIS; PSYCHOLOGICAL TREATMENT; PHYSICAL SYMPTOMS

Zurück | Weiter