The author, C M Deighton, agrees with Bass & Murphy's call for research on somatization before the Government's White Paper exacerbates the challenges of managing chronic somatizers. He highlights two key issues in this area:
1. **Abnormal Illness Behaviour**: This behavior encompasses a wide range of doctor-patient relationships, from those who malingering to those with functional symptoms they cannot control. The concept of somatization disorder, which excludes severe cases, is criticized for its limited value in British primary care.
2. **Functional and Organic Illness Overlap**: Somatization disorder does not always distinguish between patients with and without organic diseases. Many patients present with symptoms that are difficult to classify purely functionally or organically, often having both functional and organic issues. A multi-axial classification system that considers psychological, physical, social, and personality factors is necessary to address this complexity.
Deighton emphasizes that primary care is the appropriate setting for this research, as GPs are best equipped to identify and manage these patients. The upcoming NHS bill underscores the urgency of this research.The author, C M Deighton, agrees with Bass & Murphy's call for research on somatization before the Government's White Paper exacerbates the challenges of managing chronic somatizers. He highlights two key issues in this area:
1. **Abnormal Illness Behaviour**: This behavior encompasses a wide range of doctor-patient relationships, from those who malingering to those with functional symptoms they cannot control. The concept of somatization disorder, which excludes severe cases, is criticized for its limited value in British primary care.
2. **Functional and Organic Illness Overlap**: Somatization disorder does not always distinguish between patients with and without organic diseases. Many patients present with symptoms that are difficult to classify purely functionally or organically, often having both functional and organic issues. A multi-axial classification system that considers psychological, physical, social, and personality factors is necessary to address this complexity.
Deighton emphasizes that primary care is the appropriate setting for this research, as GPs are best equipped to identify and manage these patients. The upcoming NHS bill underscores the urgency of this research.