TECHNIQUES FOR INTERVIEWING THE SOMATISING PATIENT

Liaison psychistrists need to interview somatising patients in a way w hich allows a full assessment of the problem. This can best be achieve d if the psychiatrist has already discussed with the referring physici an the reason for referral and what the patient has been told about it . The medical notes should always be reviewed in detail and independen t data obtained from a relative or other informant. During the intervi ew itself the psychiatrist must be prepared to use techniques which de epen rapport with the patient, who may be initially wary or hostile. T he psychiatrist should attempt to establish early a treatment alliance . Special aspects of the mental state need to be noted, including the patient's attitude to his/her symptoms and the strength with which som atic beliefs are held. Different approaches may be used according to t he nature of the problem and the therapeutic style of the doctor. An a wareness of these interview techniques would greatly reduce the chance s of fruitless interviews with a hostile patient who believes the symp toms are being dismissed as being 'all in the mind'.