Management of somatoform disorders

Physical illness, where there is no apparent disease, is a problem for doctors and the health system. Such an illness is also a cause of distress and anguish for patients and families. General practitioners are inevitably involved.

This paper describes the technique of re-attribution used to reduce patients' somatic focus, and presents principles for the management of chronic somatizers.

General practitioners have a critical role to play with somatizing patients. For those patients presenting occasionally, or for the first time, with somatoform symptoms, GPs have the opportunity, through education, reassurance and re-attribution, to prevent reinforcement of the somatic perception and to reduce illness behaviour. In the care of patients with chronic somatizing disorders, GPs have an equally important role as case managers and carers, in order to prevent unnecessary medical interventions and to help maximise patient functioning.