Cultural Models and Somatic Syndromes

Kirmayer, Laurence J.; Sartorius, Norman

doi:10.1097/psy.0b013e31815b002c

Cited by 270 publications

(167 citation statements)

References 70 publications

Supporting

Mentioning

157

Contrasting

Unclassified

Order By: Relevance

“…Stone [29] models a destructive consultation process where doctors and patients "were unable to develop a shared framework" and go into negative looping [30] or a "duet of escalating antagonisms" [31]. For comparison, Stone [29] also models a consultation process with positive looping.…”

Section: One Way To See This [Incongruence] Is As a Reflection Of Docmentioning

confidence: 99%

What is the problem with medically unexplained symptoms for GPs? A meta -synthesis of qualitative studies

Johansen

Risør

2017

Patient Education and Counseling

101

View full text Add to dashboard Cite

Please cite this article as: Johansen May-Lill, Risor Mette Bech.What is the problem with medically unexplained symptoms for GPs? A meta-synthesis of qualitative studies.Patient Education and Counseling http://dx.doi.org/10.1016/j.pec. 2016.11.015 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights:-For GPs, dominant disease models (biomedical or psychosocial) often do not fit with reality -Both patients and doctors struggle with and suffer from this incongruence -In the lack of congruent disease models, a validating doctorpatient relationship can be a lifeline 2 Abstract:Objective To gain a deeper understanding of challenges faced by GPs when managing patients with MUS. MethodsWe used meta-ethnography to synthesize qualitative studies on GPs' perception and management of MUS. ResultsThe problem with MUS for GPs is the epistemological incongruence between dominant disease models and the reality of meeting patients suffering from persistent illness. GPs have used flexible approaches to manage the situation, yet patients and doctors have had parallel negative experiences of being stuck, untrustworthy and helpless. In the face of cognitive incongruence, GPs have strived to achieve relational congruence with their patients. This has led to parallel positive experiences of mutual trust and validation. With more experience, some GPs seem to overcome the incongruences, and later studies point towards a reframing of the MUS problem. ConclusionFor GPs, the challenge with MUS is most importantly at an epistemological level. Hence, a full reframing of the problem of MUS for GPs (and for patients) implies broad changes in basic medical knowledge and education. 3Practice Implications Short-term: Improve management of patients with MUS by transferring experience-based, reality-adjusted knowledge from senior GPs to juniors. Long-term: Work towards new models of disease that integrate knowledge from all relevant disciplines.199 words

show abstract

Section: One Way To See This [Incongruence] Is As a Reflection Of Docmentioning

confidence: 99%

What is the problem with medically unexplained symptoms for GPs? A meta -synthesis of qualitative studies

Johansen

Risør

2017

Patient Education and Counseling

101

View full text Add to dashboard Cite

show abstract

“…La somatización surge, entonces, de la interacción entre las percepciones corporales (fisiológicas o mínimamente patológicas) y la atribución psicológica (11) otorgada por el paciente .…”

Section: Fisiopatologíaunclassified

“…Cuando estos factores se retroalimentan o refuerzan pueden conducir a la instalación de círculos viciosos y de cierta forma de (9,10,11) "circuito cerrado". Estos factores pueden leerse en la tabla 2 .…”

Section: Fisiopatologíaunclassified

“…Tales interpretaciones de una amenaza grave a la salud se asocian con ansiedad, que a su vez lleva a una serie de cambios, como una búsqueda repetida de tranquilización, conductas de evitación y seguridad, comprobaciones corporales, aumento de la focalización en el cuerpo y atención selectiva a (11) informaciones relacionadas con la enfermedad .…”

Section: Fisiopatologíaunclassified

See 1 more Smart Citation

Help me doctor, I'm very sick! An update on the classic hypochondria to the current illness anxiety disorder

Torales

2017

Rev. virtual Soc. Parag. Med. Int

View full text Add to dashboard Cite

RESUMENLa característica fundamental del trastorno de ansiedad por enfermedad (antes conocido como hipocondría) es la preocupación, no por los síntomas, sino por la creencia que tiene un paciente de padecer una enfermedad. Esta creencia, basada en una interpretación errónea de signos y sensaciones corporales, genera en el paciente un intenso malestar clínicamente significativo, con disfunción notable de sus actividades de la vida diaria y con un uso exagerado de recursos de salud.El paciente recorre varios servicios médicos y es atendido por varios profesionales, incluidos especialistas en Medicina Interna, Medicina Familiar y Psiquiatría. No obstante, la creencia de estar enfermo persiste a pesar de adecuada evaluación médica y reaseguramiento. A veces, la atención médica resulta en un aumento paradójico de la ansiedad, sin soslayar la posibilidad de complicaciones derivadas de pruebas y procedimientos diagnósticos a los que el paciente es sometido. Los pacientes afectados se sienten frustrados e insatisfechos con la atención médica recibida y la consideran inútil, sintiendo que los médicos no les prestan debida atención.Con base en lo anterior, en este artículo de revisión se hace una puesta al día del concepto, la etiopatogenia, la clínica y el diagnóstico del trastorno de ansiedad por enfermedad, así como de los principios que rigen su tratamiento.Palabras claves: trastorno de ansiedad por enfermedad, hipocondría, diagnóstico, tratamiento. ABSTRACTThe fundamental characteristic of illness anxiety disorder (formerly known as hypochondria) is the concern not for the symptoms, but for the patient's idea that he or she is suffering from a disease. This belief, based on a misinterpretation of bodily signs and sensations, generates intense clinical impairment in the patient, with marked dysfunction of his or her daily activities, and with an exaggerated use of health resources.

show abstract

“…The social meaning of somatic symptoms includes their use as ways of talking about or alluding to other forms of distress. Many patients with somatic cultural idioms of distress will acknowledge the social problems that exacerbate their symptoms if they fi nd a sympathetic listener (Kirmayer & Sartorius, 2007). Somatic idioms of distress commonly embody combinations of somatic, emotional, and social meanings.…”

Section: Cultural Underpinningsmentioning

confidence: 99%

Many faces of somatic symptom disorders

Chaturvedi¹

2013

International Review of Psychiatry

View full text Add to dashboard Cite

Cultural Models and Somatic Syndromes

Cited by 270 publications

References 70 publications

What is the problem with medically unexplained symptoms for GPs? A meta -synthesis of qualitative studies

What is the problem with medically unexplained symptoms for GPs? A meta -synthesis of qualitative studies

Help me doctor, I'm very sick! An update on the classic hypochondria to the current illness anxiety disorder

Many faces of somatic symptom disorders

Contact Info

Product

Resources

About