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Somatisation

Somatisation is a critical issue in recognizing missed depression diagnoses in primary care settings. This session explores somatisation, its complexities, and effective strategies to address it through the Reattribution Model. Participants will learn about problem-based interviewing (PBI) techniques in four key stages: (1) Feeling understood, (2) Broadening the agenda, (3) Making the link to underlying issues, and (4) Negotiating appropriate treatment. Active listening and empathic communication are emphasized to foster comprehensive patient care and improved health outcomes.

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Somatisation

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  1. Somatisation

  2. 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

  3. Somatisation What is it?

  4. Somatisation What are the difficulties? (what do you want to get out of this session?)

  5. Problem based interviewing (PBI) The “reattribution” model

  6. Reattribution model Four distinct stages • Feeling understood • Broadening the agenda • Making the link • Negotiating treatment

  7. Diseaseillness model

  8. Feeling understood …active listening

  9. 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

  10. Reattribution model Four distinct stages • Feeling understood • Broadening the agenda • Making the link • Negotiating treatment

  11. Rehearsing the skills Eeek! Roleplay!

  12. Exploring PBI further http://www.gp-training.net/training/theory/pbi/pbi.htm

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