Rk. Morriss et al., Clinical and patient satisfaction outcomes of a new treatment for somatized mental disorder taught to general practitioners, BR J GEN PR, 49(441), 1999, pp. 263-267
Background. Patients with mental disorder presenting with medically unexpla
ined symptoms (somatized mental disorder) are common in primary care, diffi
cult to treat, and function poorly in their daily lives.
Aim. To examine the effects on patient outcome and satisfaction of a traini
ng package for somatized mental disorder delivered to general practitioners
(GPs).
Method. A prospective study of a before-and-after training study of differe
nt cohorts of patients attending eight GPs who acted as their own controls.
Patients were stratified according to their belief that the presenting med
ical symptom had either a partial or completely physical cause.
Results. One hundred and three patients in the cohort before training, and
112 patients in the cohort after training, were diagnosed with somatized me
ntal disorder by the study GPs. After training there were significant impro
vements in interview-rated psychiatric disorder (P = 0.032) at one month, s
elf-rated psychiatric disorder (P = 0.024), and global function (P = 0.020)
at three months in patients who believed their symptoms to have a partial
physical cause. Training at one-month follow-up reduced depressive symptoms
in patients with major depression but did not significantly change any oth
er outcome in patients who believed their symptoms had only a physical caus
e. There was no overall change in patient satisfaction.
Conclusion. Training GPs clinically benefited patients with somatized menta
l disorder who believe that their symptoms have a partial physical cause.