BACKGROUND: In daily practice general practitioners (GPs) generally rely on their clinical judgement in assessing whether patients somatise distress. Nevertheless, conclusions derived from research on somatisation in primary care are largely based on standardised measurements of somatisation. We investigated the relation between GPs' clinical judgement of somatisation and a somatisation research instrument (DSM-III-R), and examined how both operationalisations of somatisation related to other important variables. METHODS: In nine general practices, 407 frequently attending patients answered a questionnaire on somatisation symptoms, while the GPs gave their judgement on somatisation and communication for each patient. Other variables were extracted from the registered health status of the patients. RESULTS: We found a weak association (correlation: 0.27) between the GPs' judgement and the research instrument; however, relations with other variables showed that both operationalisations were very similar constructs. The research instrument incorporated more psychological problems (depression and anxiety), while the GPs' judgement of somatisation was more influenced by attendance rate and by aspects of communication with the patient. CONCLUSION: For research addressing somatisation in primary care as a practical clinical problem, the operationalisation of somatisation should include the clinical judgement of the practitioner as well, thereby widening the focus from co-morbid mental disturbances to communication aspects.
BACKGROUND: In daily practice general practitioners (GPs) generally rely on their clinical judgement in assessing whether patients somatise distress. Nevertheless, conclusions derived from research on somatisation in primary care are largely based on standardised measurements of somatisation. We investigated the relation between GPs' clinical judgement of somatisation and a somatisation research instrument (DSM-III-R), and examined how both operationalisations of somatisation related to other important variables. METHODS: In nine general practices, 407 frequently attending patients answered a questionnaire on somatisation symptoms, while the GPs gave their judgement on somatisation and communication for each patient. Other variables were extracted from the registered health status of the patients. RESULTS: We found a weak association (correlation: 0.27) between the GPs' judgement and the research instrument; however, relations with other variables showed that both operationalisations were very similar constructs. The research instrument incorporated more psychological problems (depression and anxiety), while the GPs' judgement of somatisation was more influenced by attendance rate and by aspects of communication with the patient. CONCLUSION: For research addressing somatisation in primary care as a practical clinical problem, the operationalisation of somatisation should include the clinical judgement of the practitioner as well, thereby widening the focus from co-morbid mental disturbances to communication aspects.
Authors: Norman H Rasmussen; David C Agerter; Robert C Colligan; Macaran A Baird; Charles E Yunghans; Stephen S Cha Journal: Ment Health Fam Med Date: 2008-09
Authors: Tim C olde Hartman; Peter L B J Lucassen; Eloy H van de Lisdonk; Hans H J Bor; Chris van Weel Journal: Br J Gen Pract Date: 2004-12 Impact factor: 5.386
Authors: Kaj Sparle Christensen; Tomas Toft; Lisbeth Frostholm; Eva Ørnbol; Per Fink; Frede Olesen Journal: Br J Gen Pract Date: 2003-10 Impact factor: 5.386
Authors: Joanna Leaviss; Sarah Davis; Shijie Ren; Jean Hamilton; Alison Scope; Andrew Booth; Anthea Sutton; Glenys Parry; Marta Buszewicz; Rona Moss-Morris; Peter White Journal: Health Technol Assess Date: 2020-09 Impact factor: 4.014
Authors: Peter Salmon; Adele Ring; Gerry M Humphris; John C Davies; Christopher F Dowrick Journal: J Gen Intern Med Date: 2009-01-23 Impact factor: 5.128