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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
261 Results
21
An integrated approach to the formulation and psychotherapy of medically unexplained symptoms: meaning- and attachment-based intervention
Type: Journal Article
Year: 2004
Publication Place: United States
Abstract: Persistent medically unexplained symptoms (MUS) are a serious problem because they are common, difficult to treat effectively, and have a significant impact on both functional outcomes and health-care utilization costs. An attachment-existential formulation of psychological factors that are associated with persistent MUS is presented, based on the interaction of death anxiety and preoccupied (anxious) attachment. Psychotherapeutic treatment recommendations that follow from this formulation are described in the form of a brief psychotherapy, involving semi-structured weekly sessions and narrative-writing homework that explores attachment and existential themes. This is the first description of a brief psychotherapy that integrates attachment theory and existential psychology.
Topic(s):
Medically Unexplained Symptoms
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24
Assessing medically unexplained symptoms: evaluation of a shortened version of the SOMS for use in primary care
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: To investigate the validity and stability of a Portuguese version for the Screening for Somatoform Symptoms-2 (SOMS-2) in primary care (PC) settings. METHODS: An adapted version of the SOMS-2 was filled in by persons attending a PC unit. All medically unexplained symptoms were further ascertained in a clinical interview and by contacting the patient's physicians and examining medical records, attaining a final clinical symptom evaluation (FCSE). An interview yielded the diagnosis of Clinical Somatization (CS) and the diagnosis of current depressive and anxiety disorders. RESULTS: From the eligible subjects, 167 agreed to participate and 34.1% of them were diagnosed with somatization. The correlation between the number of self-reported and FCSE symptoms was 0.63. After excluding symptoms with low frequency, low discriminative power and not correlated with the overall scale, 29 were retained in the final version. A cut-off of 4 symptoms gave a sensitivity of 86.0% and a specificity of 95.5% on the FCSE and 56.1% and 93.6% at self-report. Stability in the number of symptoms after 6 months was good (k = 0.57). CONCLUSIONS: The 29 symptoms version of the SOMS-2 with a cut-off of 4 showed a high specificity and sensitivity, being reliable as a referral tool for further specialized diagnosis.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links: 
View the DOI record for Assessing medically unexplained symptoms: evaluation of a shortened version of the SOMS for use in primary care
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View the PubMed citation for Assessing medically unexplained symptoms: evaluation of a shortened version of the SOMS for use in primary care26
Assessing psychological health in midwifery practice: A validation study of the Four-Dimensional Symptom Questionnaire (4DSQ), a Dutch primary care instrument
Type: Journal Article
Year: 2013
Publication Place: Scotland
Topic(s):
Education & Workforce
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, Medically Unexplained Symptoms
See topic collection
28
Assessment of a pilot course on the management of somatization disorder for family doctors
Type: Journal Article
Year: 2002
Publication Place: United States
Abstract: Somatization disorder (SD) patients are difficult to treat and produce negative feelings in health professionals. Smith et al.'s guidelines have demonstrated cost-effectiveness in the treatment of these patients, but family doctors consider it difficult to put these into practice in the long term. The objective of this paper is to design and assess a pilot course, based on Smith's norms, to train general practitioners for the everyday management of SD patients in primary care. We have designed a 20-h practical course, using role-playing and video recording with standardized patients, and focusing on micro-skills recommended by the literature on the subject. Assessment of the efficacy of the course is made by evaluation of baseline and post course video recordings by researchers unaware of the order of the interviews. The comparison of baseline and post course assessments demonstrated a significant improvement in several key skills (giving a name to the illness, explaining the psychological and biological basis of the disease, and emphasizing stress reduction) but no change on others (explaining that SD is a well-known disorder, empowering the patient, not blaming the patient for his or her illness, and instilling hope). Finally, other skills such as assessing the patient's opinion of the illness, recognizing the reality of symptoms and informing that there is no life risk, were correctly done from the beginning and, therefore, showed no change. We found that training may facilitate the development of certain skills. However, some doctors' abilities might also require the use of techniques such as Balint groups to modify negative emotions, such as anger and fear, toward these patients.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Assessment of a pilot course on the management of somatization disorder for family doctors
29
Association of mental distress with health care utilization and costs: A 5-year observation in a general population
Type: Journal Article
Year: 2009
Publication Place: Germany
Abstract: OBJECTIVE: Previous studies have associated mental distress and disorders with increased health care utilization and costs. However, most studies have selected subjects from treatment facilities or have applied retrospective designs. METHODS: N = 3,300 subjects from the baseline cohort of the Study of Health in Pomerania were followed up 5 years later. Mental distress was assessed with the SF-12 Health Survey and the Composite Diagnostic Screener for mental disorders. Two-part econometric models were applied adjusting for medical confounders and baseline services use. RESULTS: At 5-year follow-up somatization at baseline predicted an increase of inpatient (+39.9%) and outpatient costs (+11.9%). Depression predicted an increase of inpatient (+24.1%) and outpatient costs (+8.9%). Comorbidity of somatization and depression and somatization and anxiety predicted an increase in overall health care costs of > or =50%. CONCLUSION: Simple and time-efficient screening procedures for mental disorders may help to identify subjects at risk for increased future health care utilization. Standardized therapeutic interventions should be evaluated in subjects at risk in primary care.
Topic(s):
Financing & Sustainability
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, Medically Unexplained Symptoms
See topic collection
Reference Links:
View the DOI record for Association of mental distress with health care utilization and costs: A 5-year observation in a general population
View DOI Record
View the PubMed citation for Association of mental distress with health care utilization and costs: A 5-year observation in a general population30
Beliefs about the causes of health complaints: a study in primary care
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: In public and interpersonal health communication, a need exists to explore the nature of lay beliefs about health complaints to achieve effective communication. Beliefs of patients visiting their family physician/general practitioner (GP) may give insight into this matter. The aim of this study was to investigate the spectrum of causes attributed to different categories of health complaints presented at the GP office. Before visiting their GP, 2,253 individuals completed a questionnaire about their health complaint and the cause they attributed to this complaint. The spectrum of causes attributed to all health complaints was compared between distinct categories of health complaints. Sixty-two percent of the GP patients attributed at least 1 cause to health complaints they presented at the GP office. Thirty-eight percent of GP patients did not attribute a cause to the health complaint they presented at the GP office. Patient beliefs differed across distinct health problems. Lay beliefs seemed to differ from basic notions of illness because patients attributed different causes to different health complaints. These differences in beliefs, when patients choose to share them with their GP, may serve as a starting point for the communication between the patients and the GP to achieve an effective communication. A need seems to emerge to discriminate between lay beliefs regarding the nature of specific illnesses and those regarding basic notions. GPs are therefore advised to attend to, or at least ask for, their patients' views specifically.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links:
View the DOI record for Beliefs about the causes of health complaints: a study in primary care
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View the PubMed citation for Beliefs about the causes of health complaints: a study in primary care31
Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS)
Type: Journal Article
Year: 2003
Publication Place: England
Abstract: Patients commonly present in primary care with symptoms for which no physical pathology can be found. This study is a review of published research on medically unexplained symptoms (MUPS) in primary care. A literature review and qualitative comparison of information was carried out. Four questions were addressed: what is the prevalence of MUPS; to what extent do MUPS overlap with psychiatric disorder; which psychological processes are important in patients with MUPS; and what interventions are beneficial? Neither somatised mental distress nor somatisation disorders, based on symptom counts, adequately account for most patients seen with MUPS. There is substantial overlap between different symptoms and syndromes, suggesting they have much in common. Patients with MUPS may best be viewed as having complex adaptive systems in which cognitive and physiological processes interact with each other and with their environment. Cognitive behavioural therapy and antidepressant drugs are both effective treatments, but their effects may be greatest when the patient feels empowered by their doctor to tackle their problem.
Topic(s):
Medically Unexplained Symptoms
See topic collection
Reference Links: View the PubMed citation for Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS)
32
Body dysmorphic disorder: a guide for primary care physicians
Type: Journal Article
Year: 2002
Publication Place: United States
Abstract: Body dysmorphic disorder (BDD), a preoccupation with an imagined or slight defect in appearance, is a relatively common psychiatric disorder that often presents to nonpsychiatric physicians. Body dysmorphic disorder is associated with marked impairment in functioning, notably poor quality of life, and a high suicide attempt rate. Most patients seek and receive surgery or nonpsychiatric medical or dermatologic treatment, often with a perceived poor outcome despite an objectively acceptable result. In contrast, psychiatric treatment, serotonin-reuptake inhibitors and cognitive-behavioral therapy, often are effective. This clinically focused review describes the clinical features and prevalence of BDD, the disorder's treatment response, how to recognize and diagnose BDD, and practical suggestions for primary care physicians who encounter these often difficult-to-treat patients.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Body dysmorphic disorder: a guide for primary care physicians
33
Building Complex Care Capacity in Primary Care: An Educational Evaluation of Project ECHO Ontario Integrated Mental and Physical Health
Type: Journal Article
Year: 2022
Topic(s):
Education & Workforce
See topic collection
, Medically Unexplained Symptoms
See topic collection
, HIT & Telehealth
See topic collection
35
Case and care complexity in the medically ill
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: The authors have argued that complexity in general health care is increasingly prevalent because of the increase in patients who have multimorbid conditions, and the increased professional and technical possibilities of medicine. In the increasingly complex care systems, it is necessary-specifically when treating patients in need of integrated care by several providers-that an optimal match between case and care complexity be found in order to prevent poor outcomes in this vulnerable group. The authors discussed several approaches to case complexity that can be identified in the literature. Most of them seem unsuitable for adjusting case and care complexity, and inadequate for designing multidisciplinary care. Theoretic approaches to case complexity may be of interest, but did not result in clinically meaningful information. The INTERMED, which can be considered the first empirically based instrument to link case and care complexity, is an attempt to improve care delivery and outcomes for the complex medically ill.
Topic(s):
Medically Unexplained Symptoms
See topic collection
39
Childhood anxiety in a diverse primary care population: Parent-child reports, ethnicity and SCARED factor structure
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: OBJECTIVE: To explore in a multiethnic primary care population the impact of child gender and of race/ethnicity on parent and child reports of school-age anxiety and on the factor structure of the Screen for Childhood Anxiety and Related Emotional Disorders (SCARED). METHOD: A consecutive sample of 515 children (8 to <13 years) and their parent presenting for primary care completed self-report (C) and parent-report (P) versions of the SCARED-41. RESULTS: Neither SCARED scores nor parent-child difference varied significantly with race/ethnicity. Predictors of higher SCARED scores were less parental education, younger child age and female gender. Exploratory factor analysis conducted separately for SCARED-C and SCARED-P yielded four factors. There was large variation in factor structure between SCARED-C and SCARED-P and across ethnic and gender subgroups, greatest for somatic/panic/generalized anxiety and Hispanic children. CONCLUSIONS: Primary care triage of anxious children requires data from both the parent and child and must go beyond cross-sectional symptom inventories. Clinicians must elicit from each family their perhaps culturally bound interpretation of the child's somatic and psychological symptoms.
Topic(s):
Healthcare Disparities
See topic collection
, Medically Unexplained Symptoms
See topic collection
Reference Links:
View the DOI record for Childhood anxiety in a diverse primary care population: Parent-child reports, ethnicity and SCARED factor structure
View DOI Record
View the PubMed citation for Childhood anxiety in a diverse primary care population: Parent-child reports, ethnicity and SCARED factor structure