Approaches to management
- Recognition -
early recognition of the importance of
psychological factors can save time and avoid unnecessary
investigations and treatments
- Engagement -
good management
should facilitate the acceptance of appropriate
treatment
- Rational approach to treatment -
investigations and interventions should have clear
indications and not be pursued indefinitely
- Appropriate communication -
communication should be clear, honest and should address
psychosocial factors to the extent that the patient will
tolerate
- Appropriate attribution of aetiology -
"facultative somatisers" may benefit from a "reattribution
approach" which reformulates their distress in psychosocial
terms
- Symptomatic psychological treatment -
other patients may accept a "psychotherapeutic approach" to alleviate
the psychological distress caused by their physical symptoms
- Palliative and supportive interventions -
"chronic somatisers" may accept a "directive approach" involving a
rehabilitation program or help in coping with disability
- Treatment of psychiatric illness -
underlying or concomitant psychiatric illness should be
treated appropriately
- Empirical treatment -
some patients without manifest psychosocial distress
improve with psychotropic medication