Somatisation
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Somatisation PowerPoint PPT Presentation


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Somatisation. Somatisation. Somatisation is one of the most important single problems associated with a missed diagnosis of depression in primary care BMJ 2008;336:435-439. Somatisation. What is it?. Somatisation. What are the difficulties? (what do you want to get out of this session?).

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Somatisation

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Somatisation


Somatisation

Somatisation is one of the most important single problems associated with a missed diagnosis of depression in primary care

BMJ 2008;336:435-439


Somatisation

What is it?


Somatisation

What are the difficulties?

(what do you want to get out of this session?)


Problem based interviewing (PBI)

The “reattribution” model


Reattribution model

Four distinct stages

  • Feeling understood

  • Broadening the agenda

  • Making the link

  • Negotiating treatment


Diseaseillness model


Feeling understood

…active listening


Feeling understood

  • Take a full history

    • elicit other associated symptoms

    • ask about a typical pain day

  • Respond to mood cues

  • Clarification

    • empathic comments

    • probe mood state/thought content

  • Explore social and family factors

  • Check for biological symptoms

  • Explore patients health beliefs

  • Specific example

  • Scale

  • Carry out focussed physical examination


Reattribution model

Four distinct stages

  • Feeling understood

  • Broadening the agenda

  • Making the link

  • Negotiating treatment


Rehearsing the skills

Eeek! Roleplay!


Exploring PBI further

http://www.gp-training.net/training/theory/pbi/pbi.htm


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