Somatisation is the expression in physical symptoms of psychological distress.
This includes illnesses with or without organic pathology. Surprisingly there is still very little medical education about this common dynamic of human illness experience.
Dr Brett Mann discussed easily implemented approaches that enable you to take a history, recognise patterns of somatising illness, and safely make a positive diagnosis of somatisation.
This contrasts with the inefficiency of ‘diagnosis by exclusion’. You will learn how to help patients shift from a physical to a psychosocial focus and how to manage these illnesses in a general practice context safely. Frustrating consultations become efficient, interesting and satisfying!
Topics:
- Common patterns of somatising illness.
- How to easily ‘set the scene’ to discuss somatisation so patients don’t respond with ‘You think I’m imagining it,’ ‘You think it’s all in my head,’ ‘You think I’m not coping.’
- How to safely make a positive diagnosis based on what is there, not a diagnosis of exclusion based on what is not there.
- Four standard questions.
- Management; including recognising that many patients decide what to do themselves once they understand the connection between life circumstances and their symptoms.
Resources:
- Diagnosing somatisation in adults in the first consultation: moving beyond diagnosis by exclusion BJGP (2013)
- Mind-body connections handout - Dr Brett Mann
- The mind body network website
- Somatisation: demystifying the “ghost in the machine” bpacnz (2019)
Presenter
Dr Brett Mann
Brett has been in general practice for 32 years at the Ilam Medical Centre in Christchurch. He has been a medical educator in the GPEP1 programme since 2008. He has provided over thirty seminars for registrars, GPs and medical educators on somatisation. Recently he was invited to provide a seminar for the Christchurch gastroenterologists.
