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The cost of somatization.

J Shaw¹, F Creed

¹Department of Psychiatry, Manchester Royal Infirmary, U.K.

Journal of Psychosomatic Research

|January 1, 1991

Summary

Patients with somatic symptoms often incur high investigation costs before psychiatric referral. Understanding physician and patient factors is crucial for timely somatization disorder diagnosis and management.

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Area of Science:

Psychiatry
Health Economics

Background:

Somatic symptoms are common presentations in general medicine.
Patients with somatic symptoms are often referred late to psychiatric services.
High healthcare costs are associated with the workup of undiagnosed somatic symptom disorders.

Purpose of the Study:

To assess the costs of investigations in patients with somatic symptoms prior to psychiatric referral.
To explore the determinants of referral timing for somatization patients.

Main Methods:

Retrospective analysis of 52 consecutive patients referred to a psychiatrist for somatic symptoms.
Assessment of costs incurred from general hospital investigations.

Main Results:

Median investigation cost was £286 (range £25-£2300).
Costs were driven by physician's assessment of organic disease likelihood, not GP referral letter content.
Referral timing appears influenced by diagnostic complexity, patient psychological resistance, and physician's investigative approach.

Conclusions:

Significant healthcare costs precede psychiatric referral for somatic symptom patients.
Further research is needed to understand factors influencing early versus late psychiatric referral for somatization.
Addressing physician and patient factors may improve timely diagnosis and reduce healthcare expenditure.

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