Illness Cognition, Symptom Reporting and Somatization in Family Medicine
Biomedical practitioners hope for a simple correspondence between clinical presentation and organic pathology. Unfortunately, illness behaviour supervenes to make the relationship between illness and disease exceedingly complex. Style of symptom presentation interacts with the structure of the health-care system to determine whether patients1 distress is accurately recognized and alleviated. From 20 to 84 percent of patient visits to primary care are for somatic complaints that receive no organic diagnosis (Kellner, 1985). When psychosocial factors are noted as part of their presentations, patients with obscure somatic symptoms may be described as somatizing or hypochondriacal and referred for psychiatric evaluation of “abnormal illness behaviour” (Pilowsky, 1969). When psychosocial factors are not recognized, these patients may be exposed to lengthy diagnostic and therapeutic intervention and, when no organic explanation is forthcoming, casually reassured or abruptly told their problems are imaginary.
KeywordsFatigue Depression Anemia Turkey Rosen
Unable to display preview. Download preview PDF.
- American Psychiatric Association. (1980). Diagnostic and statistical manual, Edition III, Washington: American Psychiatric Association.Google Scholar
- Hansell, S., &Mechanic, D. (in press). Introspectiveness and adolescents symptom reporting. Journal of Human Stress.Google Scholar
- Katon, W., &Dengerink, H. A. (1983). Somatization in primary health care. In J. E. Carr, &H. A. Dengerink (Eds.), Behavioral science in the practice of medicine. New York: Elsevier Biomedical.Google Scholar
- Kirmayer, L. J. (in press). Mind and body as metaphors: Hidden values in biomedicine. In M. Lock &D. Gordon (Eds.), Knowledge and practice in medicine. Dordrecht: D. Reidel.Google Scholar
- Kleinman, A. (1980). Patients and healers in the context of culture. Berkeley: University of California Press.Google Scholar
- Leventhal, H., &Nerenz, D. R. (1985). The assessment of illness cognition. In P. Karoly (Ed.), Measurement strategies in health psychology. New York: John Wiley.Google Scholar
- Leventhal, H., Nerenz, D. R., Steele, D. J. (1985). Illness representations and coping with health threats. In A. Baum &J. Singer (Eds.), Handbook of psychology and health. Hillsdale, NJ: Erlbaum.Google Scholar
- Leventhal, H., Nerenz, D. R., &Straus, A. (1982). Self-regulation and the mechanisms for symptom appraisal. In D. Mechanic (Ed.), Symptoms, illness behavior and help-seeking. New York: Neale Watson.Google Scholar
- Pilowsky, I., &Spence, D. (1975). Patterns of illness behaviour in patients with intractable pain. Journal of Psychological Measurement, 1, 385–401.Google Scholar
- Robbins, J. M., &Greenley, J. R. (1983). Thinking about what’s wrong: Attributions of severity, cause, and duration in the problem definition stage of psychiatric help-seeking. In J. R. Greenley (Ed.), Research in Community and Mental Health, Vol. 3, Greenwich, CT: JAI Press.Google Scholar