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Understanding and caring for the distressed patient with multiple medically unexplained symptoms
E A Walker1, J Unützer, W J Katon
1Department of Psychiatry, University of Washington Medical School, Seattle 98195, USA.
The Journal of the American Board of Family Practice
|October 31, 1998
Summary
Physicians can better manage complex patients with medically unexplained symptoms by understanding predisposing, precipitating, and perpetuating factors. This model aids in developing effective strategies for these challenging cases.
Area of Science:
- Psychiatry
- Primary Care Medicine
- Behavioral Medicine
Background:
- Physicians frequently encounter patients with complex medical issues, including those with unexplained symptoms and significant distress.
- These cases can be overwhelming for both patients and healthcare providers.
- A structured approach is needed to effectively manage patients with somatization and medically unexplained symptoms.
Observation:
- A model integrating clinical experience and literature review was developed for complex patients.
- Key search terms included "difficult," "frustrating," and "somatization."
- The model focuses on understanding the multifactorial nature of patient distress.
Findings:
- The model identifies three key types of factors: predisposing (vulnerability), precipitating (onset), and perpetuating (maintenance of illness behaviors).
- Understanding these factors is crucial for managing patients with medically unexplained symptoms.
- This framework helps clinicians navigate complex patient interactions.
Implications:
- Clinicians can use this model to better tolerate and unravel complex patient distress.
- It facilitates the development of practical and effective management strategies for patients with multiple medically unexplained symptoms.
- Improved understanding can lead to better patient outcomes and reduced healthcare provider burden.
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