The somatising effect of clinical consultation: What patients and doctors say and do not say when patients present medically unexplained physical symptoms

Somatoform disorders and causal attributions in patients with suspected allergies: Do somatic causal attributions matter?

“…Furthermore, both in the free response task and on the IPQ-R, the majority of work-up patients (SFD, NoSFD) endorsed multiple illness attributions, including psychosocial ones. This confirms the view that symptom attribution is a multidimensional process, with patients holding multifaceted and coexisting explanations for their symptom(s) (Hiller et al, 2010, Rief et al, 2004Rief & Broadbent, 2007;Ring et al, 2005;Risør, 2009). The similarity in attribution styles and the predominance of mixed attributions among both SFD and NoSFD patients further illustrate that patients are generally open to a bio-psycho-social illness model, in particular in a work-up situation.…”

Worries are the mother of many diseases: General practitioners and refugees in the Netherlands on stress, being ill and prejudice

“…GPs often miss cues to start discussing psychosocial issues [53,54]. Ring et al [26] concluded that the focus of attention should be more on a doctor's tendency to offer somatic interventions and neglect psychological cues, than on special characteristics of patients. Our interviews illustrate that GPs sometimes consciously order diagnostic interventions to wind up the consultation or because they feel unable to communicate in another way.…”

“…Ring et al [25] demonstrated from audio taped consultations that patients with unexplained physical symptoms often did not directly request physical interventionsbut the GPs felt pressurised by the style of presentation. GPs were found to offer little effective explanation or empathy in consultations with patients presenting MUPS [26].…”

A taxonomy of explanations in a general practitioner clinic for patients with persistent “medically unexplained” physical symptoms

“…We considered using a number of existing consultation coding schemes [35][36][37] but these largely focus on the structure of the consultation and communication within it rather than the detailed content of explanations. We found descriptive reports of explanation types used by patients [38] and doctors [25] but none had the detailed two-level structure which we found necessary to classify the explanations in our studies.…”