Managing physical symptoms: The clinical assessment as treatment

Journal/Book: J Psychosom Res. 2000; 48: the Boulevard Langford Lane, Kidlington, Oxford Ox5 1GB, England. Pergamon-Elsevier Science Ltd. 1-10.

Abstract: Physical symptoms are a common cause of attendance at general hospital out-patient clinics. There is good evidence that cognitive therapy is effective in the management of such physical symptoms. This narrative review suggests that the assessment itself, without formal psychological therapy, may be used as a treatment, regardless of whether relevant pathology is absent or present. Changing patients' beliefs about their symptoms may improve a broad range of outcomes, including symptoms, disability, distress, and health-care resource use. The evidence for investigations as treatment is reviewed, along with potential for further development and possible pitfalls. A rationale is presented for a brief psychoeducational intervention that can be delivered in the clinic. This would be a logical extension of the kind of simple explanation and reassurance that occurs routinely today, but which is not explicitly used as, or regarded as, treatment. The dearth of relevant evidence is emphasized, and recommendations are made for future research.

Note: Review Price JR, Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford OX3 7JX, ENGLAND

Keyword(s): cognitive-behavioral model; diagnostic techniques and procedures; physician-patient relations; symptoms; treatment outcome; RANDOMIZED CONTROLLED TRIAL; CHRONIC FATIGUE SYNDROME; FUNCTIONAL ABDOMINAL COMPLAINTS; COGNITIVE-BEHAVIOR THERAPY; NONCARDIAC CHEST PAIN; CHRONIC PELVIC PAIN; TERM FOLLOW-UP; PANIC DISORDER; PSYCHOLOGICAL TREATMENT; MEDICAL CONSULTATIONS

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