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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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Somatisation1

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


Somatisation2

Somatisation

What is it?


Somatisation3

Somatisation

What are the difficulties?

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


Problem based interviewing pbi

Problem based interviewing (PBI)

The “reattribution” model


Reattribution model
Reattribution model

Four distinct stages

  • Feeling understood

  • Broadening the agenda

  • Making the link

  • Negotiating treatment


Disease illness model
Diseaseillness model


Feeling understood

Feeling understood

…active listening


Feeling understood1
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 model1
Reattribution model

Four distinct stages

  • Feeling understood

  • Broadening the agenda

  • Making the link

  • Negotiating treatment


Rehearsing the skills

Rehearsing the skills

Eeek! Roleplay!


Exploring pbi further

Exploring PBI further

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