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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
202
Somatization in primary care: A comparative survey of immigrants from various ethnic groups in Rome, Italy
Type: Journal Article
Year: 2005
Publication Place: United States
Abstract: OBJECTIVES: Those responsible for interviewing immigrants in primary care settings often underestimate the importance of somatic symptoms arising from psychological distress. This study investigates the current prevalence of somatization in immigrants, and evaluates the comparative rates of somatic complaints in four ethnic groups (Caucasians, Asians, South/Center Americans, and Africans). METHODS: We studied the 301 consecutive outpatients (aged between 16 and 70 years) attending the "Caritas" primary care unit for immigrants in Rome (Italy) from January to December 2003, all of whom completed the 21-item version of the Bradford Somatic Inventory (BSI-21). Patients scoring 14 or more on the BSI-21 were considered at risk for somatization. RESULTS: The current prevalence of somatization was 35.2%; 62.3% of the somatizers were women. A multiple regression analysis adjusting for the possible confounding effects of sex, age, education, and months of stay in Italy showed that South/Central Americans had significantly higher somatization scores than the other three groups. CONCLUSIONS: These findings suggest a high probability of somatization syndromes in immigrant patients. South/Central Americans tend to somatize more than other ethnic groups. A psychosomatic approach may be useful for immigrants in primary care settings.
Topic(s):
Healthcare Disparities
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, Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Somatization in primary care: A comparative survey of immigrants from various ethnic groups in Rome, Italy
204
Somatization, heartsink patients, or functional somatic symptoms? Towards a clinical useful classification in primary health care
Type: Journal Article
Year: 2005
Publication Place: URL
Abstract: Several definitions of somatization exist and try to deal with the fundamental problem that a large group of patients present with physical symptoms for which a conventional pathology cannot be identified. However, the concept remains somewhat confusing. The prevalence of somatization is high in general practice. Nevertheless, patients do not receive proper treatment and risk iatrogenic somatic fixation and harm, the doctor-patient relationship is often negatively affected and the overall healthcare system suffers from high expenditure on unnecessary physical investigations and treatments. During the last decade research has shown that somatization may be treated effectively in specialist care. Little is known about effective treatment in primary care but the Reattribution Model and the Extended Reattribution and Management Model have shown promising results. The development and evaluation of new treatment strategies is, however, hampered by the confusion of definitions and concepts. In this article an overview is presented of the various concepts relevant to the clinical work and research in primary health care. It is important to realize that somatizing patients in primary health care present a broader spectrum of severity than patients seen in a specialist setting. Hence, primary care cannot apply definitions from specialist care directly but needs a definition that also includes the mild cases. We need classifications and agreed definitions applicable in primary health care in order to develop appropriate management strategies, to predict prognosis, and to enable rigorous research concerning the large group of somatizing patients in primary health care.
Topic(s):
Medically Unexplained Symptoms
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206
Somatizing frequent attenders in primary health care
Type: Journal Article
Year: 2001
Publication Place: England
Abstract: OBJECTIVE: The aim of this case-control study was to investigate the association of somatization with frequent attendance in primary health care. METHODS: Frequent attenders in a health center (FAs) (N=112) and age- and sex-matched controls (COs) (N=105) constituted the study series. Data were collected from annual statistics, medical records, postal questionnaires and personal interviews. Psychological distress was assessed using Symptom Checklist-36 (SCL-36), alexithymia was measured with Toronto Alexithymia Scale-20 (TAS-20) and hypochondriasis was screened with Whiteley Index (WI). RESULTS: About one-third of FAs were somatizers when a cut-off point of eight symptoms on the SCL-36 somatization subscale was used as a criterion. The significant association of somatization with frequent attendance disappeared in multivariate analyses when adjusted for age, sex and chronic somatic illnesses. Hypochondriacal beliefs and psychiatric comorbidity were connected with FAs' somatization. Hypochondriacal beliefs explained somatizers' frequent attendance. A significant interaction effect between somatization and hypochondriacal beliefs was found when explaining frequent attendance. CONCLUSION: The results emphasize the need to use a comprehensive approach of somatization, including hypochondriacal beliefs, when treating somatizing FA patients in primary health care.
Topic(s):
Financing & Sustainability
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, Medically Unexplained Symptoms
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207
Somatoform disorder in primary care: course and the need for cognitive-behavioral treatment
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: Medically unexplained physical symptoms are prevalent in primary care. Of all patients attending the family physician, 16% have a somatoform disorder as described by DSM-IV. Cognitive-behavioral treatment has been demonstrated to be effective in secondary care. However, the course of somatoform disorders and their need for treatment have not yet been established in primary care. In this study, data from 1,046 attendees in family practice were analyzed for prevalence, course, and eligibility for treatment. Over a 6-month follow-up, the prevalence of somatoform disorder decreased from 16.1% to 12.3%. After assessment of eligibility, about 5% of patients demonstrated a need for treatment.
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Somatoform disorder in primary care: course and the need for cognitive-behavioral treatment
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View the PubMed citation for Somatoform disorder in primary care: course and the need for cognitive-behavioral treatment210
Somatoform disorders in primary care and inpatient settings
Type: Journal Article
Year: 2004
Publication Place: Switzerland
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Somatoform disorders in primary care and inpatient settings
211
Somatoform disorders: a help or hindrance to good patient care?
Type: Journal Article
Year: 2004
Publication Place: England
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Somatoform disorders: a help or hindrance to good patient care?
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View the PubMed citation for Somatoform disorders: a help or hindrance to good patient care?214
Symptom presentation, interventions, and outcome of emotionally-distressed patients in primary care
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: BACKGROUND: Patients with psychosocial problems often present somatic symptoms in primary care. OBJECTIVE: The authors compare interventions and outcomes of emotionally-distressed patients by presenting physical disease, somatoform symptoms, or psychological symptoms. METHOD: General practitioners (N=191) documented data from 1,286 patients with psychosocial problems. Experts rated the presented reasons for encounter. RESULTS: Somatoform symptoms, as well as physical disease, result in patients' receiving physical treatments. Psychologically-oriented treatment is more likely with psychological presentation, but not significantly related to somatoform symptoms. CONCLUSION: These findings underline the importance of a specific treatment approach for patients with somatoform symptoms, so as to avoid inappropriate treatment.
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Symptom presentation, interventions, and outcome of emotionally-distressed patients in primary care
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View the PubMed citation for Symptom presentation, interventions, and outcome of emotionally-distressed patients in primary care215
Taking consultation-liaison psychiatry into primary care
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: Up to 50% of patients seen in primary care have mental health problems, the severity and duration of their problems often being similar to those of individuals seen in the specialized sector. This article describes the reasons, advantages, and challenges of collaborative or shared care between primary and mental health teams, which are similar to those of consultation-liaison psychiatry. In both settings, clinicians deal with the complex interrelationships between medical and psychiatric disorders. Although initial models emphasized collaboration between family physicians, psychiatrists, and nurses, collaborative care has expanded to involve patients, psychologists, social workers, occupational therapists, pharmacists, and other providers. Several factors are associated with favorable patient outcomes. These include delivery of interventions in primary care settings by providers who have met face-to-face and/or have pre-existing clinical relationships. In the case of depression, good outcomes are particularly associated with approaches that combined collaborative care with treatment guidelines and systematic follow-up, especially for those with more severe illness. Family physicians with access to collaborative care also report greater knowledge, skills, and comfort in managing psychiatric disorders, even after controlling for possible confounders such as demographics and interest in psychiatry. Perceived medico-legal barriers to collaborative care can be addressed by adequate personal professional liability protection on the part of each practitioner, and ensuring that other health care professionals with whom they work collaboratively are similarly covered.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Taking consultation-liaison psychiatry into primary care
216
Teaching about medically unexplained symptoms at medical schools in the United Kingdom
Type: Journal Article
Year: 2012
Publication Place: United Kingdom
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Teaching about medically unexplained symptoms at medical schools in the United Kingdom
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View the PubMed citation for Teaching about medically unexplained symptoms at medical schools in the United Kingdom219
Ten years of integrated care for mental disorders in the Netherlands
Type: Journal Article
Year: 2011
Publication Place: Netherlands
Abstract: BACKGROUND AND PROBLEM STATEMENT: Integrated care for mental disorders aims to encompass forms of collaboration between different health care settings for the treatment of mental disorders. To this end, it requires integration at several levels, i.e. integration of psychiatry in medicine, of the psychiatric discourse in the medical discourse; of localization of mental health care and general health care facilities; and of reimbursement systems. DESCRIPTION OF POLICY PRACTICE: Steps have been taken in the last decade to meet these requirements, enabling psychiatry to move on towards integrated treatment of mental disorder as such, by development of a collaborative care model that includes structural psychiatric consultation that was found to be applicable and effective in several Dutch health care settings. This collaborative care model is a feasible and effective model for integrated care in several health care settings. The Bio Psycho Social System has been developed as a feasible instrument for assessment in integrated care as well. DISCUSSION: The discipline of psychiatry has moved from anti-psychiatry in the last century, towards an emancipated medical discipline. This enabled big advances towards integrated care for mental disorder, in collaboration with other medical disciplines, in the last decade. CONCLUSION: Now is the time to further expand this concept of care towards other mental disorders, and towards integrated care for medical and mental co-morbidity. Integrated care for mental disorder should be readily available to the patient, according to his/her preference, taking somatic co-morbidity into account, and with a focus on rehabilitation of the patient in his or her social roles.
Topic(s):
Medically Unexplained Symptoms
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, Healthcare Policy
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Reference Links: View the PubMed citation for Ten years of integrated care for mental disorders in the Netherlands
220
The association between somatization and disability in primary care patients
Type: Journal Article
Year: 2015
Publication Place: England
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for The association between somatization and disability in primary care patients
View DOI Record
View the PubMed citation for The association between somatization and disability in primary care patients