Personal and pathopsychological features of patients with somatoform disorders in primary care

2017 ◽  
Vol 41 (S1) ◽  
pp. S417-S418
Author(s):  
B. Tsygankov ◽  
A. Kulichenko
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Somatoform Disorders ◽  
Psychometric Evaluation ◽  
Personal Characteristics ◽  
Pain Disorder ◽  
Somatization Disorder ◽  
Obsessive Compulsive ◽  
Somatoform Pain Disorder

IntroductionSomatoform disorders are a therapeutic challenge for primary care physicians. Various studies show low efficacy of psychotherapy for these patients, and the need for differentiated approach to their treatment.ObjectiveExplore the differences between pathopsychological, personal characteristics of patients with somatoform disorders.MethodsIt was carried out psychometric evaluation of 108 patients with different clinical variants of somatoform disorders, using SCL-90-r, Leonhard questionnaire.ResultsPatient with somatization disorder (SD) had maximum values on the “somatization”, “depression”, “hostile”, “paranoid” scales; a high level of anxiety. Singularity personality structure of these patients defining feature of exaltation, excitability, emotivity. Patients with undifferentiated somatoform disorder (USD) also showed high levels of somatization, anxiety and obsessive-compulsive, interpersonal sensitivity, phobic anxiety. Patients with stable somatoform pain disorder (SPD), had high levels of depression, obsessive-compulsive. SPD formed in individuals with features of anxiety, seizing, high emotivity. The maximum values for the scales of anxiety (ANX, PHOB) recorded in patients with somatoform dysfunction of the autonomic nervous system (SDANS). Evaluation of coping strategies showed a preferential use of the “avoidance” strategy by patients with SD, USD, a rare use of social support strategies, responsibility. Patients with somatoform pain disorder often resorted to seek social support.ConclusionThe use of the questionnaire SCL-90-r has identified a number of clinical features of patients with different variants of the SFD. Typologically in all samples of patients revealed moderate accentuation on emotivity trait.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Common mental disorders among patients attending monk healers and primary health care centres in Thailand: a cross-sectional study

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Somatization Disorder ◽  
Generalized Anxiety ◽  
Major Depressive ◽  
Health Centres

Abstract Background This study aimed to assess the rate of common mental disorders in patients consulting monk healers or health centres in Thailand. Methods Patients consecutively consulting monk healers or health centres were assessed with screening measures of three common mental disorders (major depressive, general anxiety and somatization disorder). Results The prevalence of any common mental disorder was significantly higher in patients attending monk healers (31.1%) than those attending primary care health centres (22.3%) (P < 0.001). Likewise, the prevalence of each common mental disorder was significantly higher in clients attending monk healers (major depressive disorder 21.0%, generalized anxiety disorder 8.1%, and somatization disorder 19.0%) than in patients attending health centres (major depressive disorder 15.8%, generalized anxiety disorder 3.5%, and somatization disorder 12.5%). In adjusted logistic regression analysis among patients of monk healers, female sex, being single, divorced, separated or widowed, and low social support were associated with any common mental disorder. Among patients of a health centre, lower education, not employed, high debt status and low social support were associated with any common mental disorder. Conclusion The study found a higher prevalence of common mental disorders in patients consulting monk healers than primary care centre attendees, calling for integrated management of common mental disorders.

scholarly journals Healing journey: a qualitative analysis of the healing experiences of Americans suffering from trauma and illness

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016771 ◽  
Author(s):  
John Glenn Scott ◽  
Sara L Warber ◽  
Paul Dieppe ◽  
David Jones ◽  
Kurt C Stange
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Personal Characteristics ◽  
Positive Reframing ◽  
Healing Journey ◽  
Helping Others ◽  
Developmental Life Cycle ◽  
Depth Interviews ◽  
Over Time

ObjectivesTo elucidate pathways to healing for people having suffered injury to the integrity of their function as a human being.MethodsA team of physician-analysts conducted thematic analyses of in-depth interviews of 23 patients who experienced healing, as identified by six primary care physicians purposefully selected as exemplary healers.ResultsPeople in the sample experienced healing journeys that spanned a spectrum from overcoming unspeakable trauma and then becoming healers themselves to everyday heroes functioning well despite ongoing serious health challenges.The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.In the healing journey, bridges from suffering are developed to healing resources/skills and connections to helpers outside themselves. These bridges often evolve in fits and starts and involve persistence and developing a sense of safety and trust.From the iteration between suffering and developing resources and connections, a new state emerges that involves hope, self-acceptance and helping others. Over time, this leads to healing that includes a sense of integrity and flourishing in the pursuit of meaningful goals and purpose.ConclusionMoving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.

Mental disorders in primary care: prevalence and co-morbidity among disorders. Results from the Functional Illness in Primary care (FIP) study

2005 ◽  
Vol 35 (8) ◽  
pp. 1175-1184 ◽  
Author(s):  
TOMAS TOFT ◽  
PER FINK ◽  
EVA OERNBOEL ◽  
KAJ CHRISTENSEN ◽  
LISBETH FROSTHOLM ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Alcohol Abuse ◽  
Anxiety Disorders ◽  
Somatoform Disorders ◽  
Psychiatric Morbidity ◽  
Somatization Disorder ◽  
Waiting Room ◽  
Co Morbidity ◽  
Icd 10

Background. Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and sociodemographics are sketchy.Method. A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18–65 years, consulting 28 family practices during March–April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness.Results. Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35·9% (95% CI 30·4–41·9), anxiety disorders 16·4% (95% CI 12·7–20·9), mood disorders 13·5% (95% CI 11·1–16·3), organic mental disorders 3·1% (95% CI 1·6–5·7) and alcohol abuse 2·2% (95% CI 1·5–3·1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%.Conclusions. ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.

scholarly journals Reducing Primary Care Provider Burnout With Pharmacist-Delivered Comprehensive Medication Management

2020 ◽  
pp. 155982762097653
Author(s):  
Nicole White
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Medication Management ◽  
Well Being ◽  
Medical Specialty ◽  
The United States ◽  
Primary Care System ◽  
Physician Perspectives ◽  
Team Based Care

Primary care physicians have among the highest rates of burnout of any medical specialty in the United States. Team-based care is an organizational approach to meet the increasing demands on the primary care system, including the well-being of its providers. Physicians report that pharmacist-delivered comprehensive medication management improves patient care efficiency, decreases workload and provides additional work-based social support, among other benefits. Physician perspectives as well as resources for implementing physician-pharmacist collaborations are discussed.

The Classification of Mental Disorders in Primary Care: A Guide through a Difficult Terrain

1998 ◽  
Vol 28 (2) ◽  
pp. 159-176 ◽  
Author(s):  
Henk Lamberts ◽  
Kathryn Magruder ◽  
Roger G. Kathol ◽  
Harold A. Pincus ◽  
Inge Okkes
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Primary Care Physicians ◽  
Common Mental Disorders ◽  
Classification Systems ◽  
Somatization Disorder ◽  
Icd 10 ◽  
Dsm Iv ◽  
Difficult Terrain ◽  
Clinical Comparability

Background: Primary care physicians traditionally have a strong interest in the mental health of their patients. Three classification systems are available for them to diagnose, label, and classify mental disorders: 1) The ICD-10 approach with three options, 2) The DSM-IV approach with two options, and 3) the ICPC approach with two options. This article lists important similarities and differences between the systems to help potential users choose the option that best meets their needs. Methods: Definitions for depressive disorder, anxiety disorder, and somatization disorder are compared on five characteristics of classification: 1. the domain, 2. the scope, 3. the nature of the definitions, 4. focus on episodes of care, and 5. clinical guidelines. Results: Primary care physicians and psychiatrists have different perspectives, reflected in different classifications. Each system has specific possibilities and limitations with regard to the diagnosis of mental disorders. For common mental disorders it is possible, however, to choose codes from one system while maintaining compatibility with the other two. Comparability as to the diagnostic content of the different classes, however, is more difficult to establish. The available classification systems give both primary care physicians and psychiatrists options to diagnose, label, and to classify mental disorders from their own perspective, but once a system has been chosen the clinical comparability of a patient with the same diagnosis in other systems is limited. Conclusion: Compatibility among systems can be optimized by strictly following a number of rules. The conversion between ICPC and ICD-10 (and consequently DSM-IV) allows simultaneous use of ICPC and ICD-10 as a classification and DSM-IV as the standard nomenclature. This is of particular interest for computer based patient records in primary care. The clinical comparability of the same diagnosis in different systems however is limited by the characteristics of the different system.

Improving the Biopsychosocial Competence of German Primary Care Physicians in Diagnosing and Treating Somatoform Disorders.

2004 ◽  
Vol 22 (3) ◽  
pp. 352-364 ◽  
Author(s):  
Kurt Fritzsche ◽  
Astrid Larisch ◽  
Manfred Cierpka ◽  
Michael Wirsching
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Somatoform Disorders

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

1566: BPH Management in an HMO Setting: Differences between Primary Care Physicians and Urologists

2007 ◽  
Vol 177 (4S) ◽  
pp. 517-517
Author(s):  
John M. Hollingsworth ◽  
Stephanie Daignault ◽  
Brent K. Hollenbeck ◽  
John T. Wei
Keyword(s):  
Primary Care ◽  
Primary Care Physicians
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