We describe a methodology for systematically approaching patients with difficulties of a psychological and social nature. Definitions are given for various types of psychosomatic difficulties, and their origins are linked to two theoretical perspectives; namely, the sick role model and family systems theory. An approach to the assessment of the individual with regard to school, peer, and family relationships is offered, and methods of gathering information associated with the presenting complaint are described. Approaches to treatment are reviewed, and appropriate applications are suggested.
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References
1.
Gardner E.Emotional disorders in medical practice. Ann Intern Med1970;73:651-3.
2.
Starfield B. , Gross E., Wood M.Psychosocial and psychosomatic diagnosis in primary care of children. Pediatrics1980;66: 159-67.
3.
Williams C., Logal M.Chronic pain in adolescence: psychological considerations. In Blum R, ed. Chronic Illness and Disabilities in Childhood and Adolescence, New York: Grune & Stratton, 1984.
4.
Maloney M.Diagnosing hysterical conversion reactions in children. Pediatrics1980;97:1016-20.
5.
McKegney F.The incidence and characteristics of patients with conversion reaction: a general hospital consultative service sample. Am J Psychiatry1967;124:542-51.
6.
Herman R., Simonds G.Incidence of conversion symptoms of children evaluated psychiatrically . Missouri Med1975;72: 597-604.
7.
Goodwin J., Gross M.Pseudoseizures and incest. Am J Psych1979 ;136:1231-3.
8.
Barsky A., Klerman G.Overview: hyperchondriasis, bodily complaint and somatic styles. Am J Psychiatry1983;140: 273-83.
9.
Kenyon F.Hyperchondriasis: a clinical study. Br J Psychiatry1964;110:478-88.
10.
Garner H.Malingering. III Med J1965;128:318-9.
11.
Szasz T.Malingering: "diagnosis" or social condemnation? Arch of Neurol Psych1956;77:432-43.
12.
Ford C.The Somatizing Disorders. New York: Elsevier Biomedical, 1983.
Parsons T.Definitions of health and illness in light of American values and social structure . In Jaco E, ed. Physicians and Illness: A Sourcebook in Behavioral Science & Health , 2nd ed., New York: Free Press, 1972.
15.
Zborowski M.Cultural components in response to pain. J Soc Issues1952;8:16-30.
16.
Beecher H.Measurement of Subjective Responses. New York: Oxford University Press, 1959.
17.
Minuchin S. , Baker L., Rosman B., et al. A conceptual model of psychosomatic illness in children. Arch Gen Psych1975;32: 1031-8.
