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Enhanced care by generalists for functional somatic symptoms and disorders in primary care

  1. Marianne Rosendal1,*,
  2. Annette H Blankenstein2,
  3. Richard Morriss3,
  4. Per Fink4,
  5. Michael Sharpe5,
  6. Christopher Burton6

Editorial Group: Cochrane Common Mental Disorders Group

Published Online: 18 OCT 2013

Assessed as up-to-date: 13 AUG 2012

DOI: 10.1002/14651858.CD008142.pub2


How to Cite

Rosendal M, Blankenstein AH, Morriss R, Fink P, Sharpe M, Burton C. Enhanced care by generalists for functional somatic symptoms and disorders in primary care. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD008142. DOI: 10.1002/14651858.CD008142.pub2.

Author Information

  1. 1

    Aarhus University, Research Unit for General Practice, Institute of Public Health, Århus, Denmark

  2. 2

    VU University Medical Center, Department of General Practice and Elderly Care Medicine, Amsterdam, Netherlands

  3. 3

    University of Nottingham, Psychiatry, Nottingham, UK

  4. 4

    Århus University Hospital, Research Clinic for Functional Disorders and Psychosomatics, Århus, Denmark

  5. 5

    University of Oxford, Department of Psychiatry, Oxford, UK

  6. 6

    University of Aberdeen, Centre of Academic Primary Care, Aberdeen, UK

*Marianne Rosendal, Research Unit for General Practice, Institute of Public Health, Aarhus University, Bartholins Alle 2, Århus, DK-8000, Denmark. m.rosendal@alm.au.dk.

Publication History

  1. Publication Status: New
  2. Published Online: 18 OCT 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Blankenstein 2001 {published data only (unpublished sought but not used)}
  • Blankenstein AH. Somatising patients in general practice. Reattribution, a promising approach (PhD thesis). Amsterdam: Vrije Universiteit, 2001. [: http://dspace.ubvu.vu.nl/handle/1871/11723?show=full (accessed 30 July 2013)]
Larisch 2004 {published data only (unpublished sought but not used)}
  • Larisch A, Schweickhardt A, Wirsching M, Fritzsche K. Psychosocial interventions for somatizing patients by the general practitioner: a randomized controlled trial. Journal of Psychosomatic Research 2004;57(6):507-14.
  • Schweickhardt A, Larisch A, Fritzsche K. Differentiation of somatizing patients in primary care: why the effects of treatment are always moderate. Journal of Nervous and Mental Diseases 2005;193(12):813-9.
Morriss 2006 {published data only (unpublished sought but not used)}
  • Dowrick C, Gask L, Hughes JG, Charles-Jones H, Hogg JA, Peters S, et al. General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study. BMC Family Practice 2008;9:46.
  • Morriss R. Specific psychosocial interventions for somatizing patients by the general practitioner: a randomised controlled trial.[comment]. Journal of Psychosomatic Research 2004;57(6):515-6.
  • Morriss R, Dowrick C, Salmon P, Peters S, Dunn G, Rogers A, Gask L. "Reattribution for medically unexplained symptoms": Authors' reply. British Journal of Psychiatry 2008;192(4):315.
  • Morriss R, Dowrick C, Salmon P, Peters S, Dunn G, Rogers A, et al. Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms. British Journal of Psychiatry 2007;191:536-42.
  • Morriss R, Dowrick C, Salmon P, Peters S, Rogers A, Dunn G, et al. Turning theory into practice: rationale, feasibility and external validity of an exploratory randomized controlled trial of training family practitioners in reattribution to manage patients with medically unexplained symptoms (the MUST). General Hospital Psychiatry 2006;28(4):343-51.
  • Morriss R, Gask L, Dowrick C, Dunn G, Peters S, Ring A, et al. Randomized trial of reattribution on psychosocial talk between doctors and patients with medically unexplained symptoms. Psychol.Med. 2010;40(2):325-33.
  • van Ravesteijn Hiske J, Lucassen PL, Olde Hartman TC. Reattribution for medically unexplained symptoms. British Journal of Psychiatry 2008;192(4):314-5.
Rief 2005 {published and unpublished data}
  • Rief W, Martin A, Rauh E, Zech T, Bender A. Evaluation of general practitioners' training: how to manage patients with unexplained physical symptoms. Psychosomatics 2006;47(4):307-11.
Rosendal 2000 {published data only (unpublished sought but not used)}
  • Rosendal M, Bro F, Fink P, Christensen KS, Olesen F. Diagnosis of somatisation: effect of an educational intervention in a cluster randomised controlled trial. The British Journal of General Practice 2003;53:917-22.
  • Rosendal M, Bro F, Sokolowski I, Fink P, Toft T, Olesen F. A randomised controlled trial of brief training in assessment and treatment of somatisation: Effects on general practitioners' attitudes. Family Practice 2005; Vol. 22:419-27.
  • Rosendal M, Olesen F, Fink P, Toft T, Sokolowski I, Bro F. A randomized controlled trial of brief training in the assessment and treatment of somatization in primary care: effects on patient outcome. General Hospital Psychiatry 2007;29(4):364-73.
Toft 2000 {published and unpublished data}
  • Christensen KS, Toft T, Frostholm L, Ornbol E, Fink P, Olesen F. Screening for common mental disorders: who will benefit? Results from a randomised clinical trial. Family Practice 2005;22(4):428-34.
  • Christensen KS, Toft T, Frostholm L, Ornbol E, Fink P, Olesen F. The FIP Study: A randomised, controlled trial of screening and recognition of psychiatric disorders. The British Journal of General Practice 2003;53(495):758-63.
  • Fink P, Rosendal M, Toft T. Assessment and treatment of functional disorders in general practice: the extended reattribution and management model - an advanced educational program for nonpsychiatric doctors. Psychosomatics 2002;43(0033-3182, 2):93-131.
  • Frostholm L, Fink P, Oernboel E, Christensen KS, Toft T, Olesen F, et al. The uncertain consultation and patient satisfaction: the impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills. Psychosomatic Medicine 2005;67(6):897-905.
  • Frostholm L, Fink P, Oernboel E, Christensen KS, Toft T, Olesen F, et al. The uncertain consultation and patient satisfaction: the impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills. Psychosomatic Medicine 2005;67(6):897-905.
  • Hansen HS, Rosendal M, Oernboel E, Fink P. Are medically unexplained symptoms and functional disorders predictive for the illness course? A two-year follow-up on patients' health and health care utilisation. Journal of Psychosomatic Research 2011;71(1):38-44.
  • Toft T, Fink P, Oernboel E, Christensen KS, Frostholm L, Olesen F. Mental disorders in primary care: prevalence and co-morbidity among disorders. Results from the Functional Illness in Primary care (FIP) study. Psychological Medicine 2005;35(8):1175-84.
  • Toft T, Rosendal M, Ornbol E, Olesen F, Frostholm L, Fink, P. Training general practitioners in the treatment of functional somatic symptoms: effects on patient health in a cluster-randomised controlled trial (the Functional Illness in Primary Care study). Psychotherapy and Psychosomatics 2010;79(4):227-37.
Whitehead 2002 {published data only}
  • Whitehead L, Campion P. Can general practitioners manage Chronic Fatigue Syndrome? A controlled trial. Journal of Chronic Fatigue Syndrome 2002;10(1):55-64.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Aiarzaguena 2007 {published data only}
  • Aiarzaguena JM, Grandes G, Gaminde I, Salazar A, Sanchez A, Arino J, et al. A randomized controlled clinical trial of a psychosocial and communication intervention carried out by GPs for patients with medically unexplained symptoms. Psychological Medicine 2007;37(2):283-94.
Alamo 2002 {published data only}
  • Alamo MM, Moral RR, Perula de Torres LA. Evaluation of a patient-centred approach in generalized musculoskeletal chronic pain/fibromyalgia patients in primary care. Patient Education and Counseling 2002;48(1):23-31.
Allen 2006 {published data only}
  • Allen LA, Woolfolk RL, Escobar JI, Gara MA, Hamer RM. Cognitive-behavioral therapy for somatization disorder: a randomized controlled trial. Archives of Internal Medicine 2006;166(14):1512-8.
Bakker 2007 {published data only}
  • Bakker IMT. A cluster-randomised trial evaluating an intervention for patients with stress-related mental disorders and sick leave in primary care. PLoS Clinical Trials 2007;2(6):e26.
Barsky 2004 {published data only}
Bernal 1995 {published data only}
  • Bernal I, Cercos A, Fuste I, Vallverdu R, Urbieta Solana R, Montesinos Molina I. Relaxation therapy in patients with anxiety and somatoform disorders in primary-care [Tratamiento de relajacion en pacientes con trastornos de ansiedad y somatoformes en atencion primaria]. Atencion Primaria 1995;15(8):499-504.
Escobar 2004 {published data only}
  • Escobar JI, Gara M, Alex I, Allen L, Diaz-Martinez A, Warman M. Treatment of patients presenting with unexplained physical symptoms in primary care. Neuropsychopharmacology 2004;29 Suppl 1:S101.
  • Escobar JI, Gara MA, Diaz-Martinez AM, Interian A, Warman M, Allen LA, et al. Effectiveness of a time-limited cognitive behavior therapy type intervention among primary care patients with medically unexplained symptoms. Annals of Family Medicine 2007;5(4):328-35.
Huibers 2004 {published data only}
  • Huibers MJ, Beurskens AJ, van Schayck CP, Bazelmans E, Metsemakers JF, Knottnerus JA, et al. Efficacy of cognitive-behavioural therapy by general practitioners for unexplained fatigue among employees: Randomised controlled trial. British Journal of Psychiatry 2004;184:240-6.
  • Huibers MJ, Bleijenberg G, Van Amelsvoort LGPM, Beurskens AJ, Van Schayck CP, Bazelmans E, et al. Predictors of outcome in fatigued employees on sick leave: Results from a randomised trial. Journal of Psychosomatic Research 2004;57(5):443-9.
  • Huibers MJ, Leone SS, van Amelsvoort LG, Kant I, Knottnerus JA. Associations of fatigue and depression among fatigued employees over time: a 4-year follow-up study. Journal of Psychosomatic Research 2007;63(2):137-42.
  • Leone SS, Huibers MJ, Kant I, van Amelsvoort LG, Van Schayck CP, Bleijenberg G, et al. Long-term efficacy of cognitive-behavioral therapy by general practitioners for fatigue: a 4-year follow-up study. Journal of Psychosomatic Research 2006;61(5):601-7.
Jellema 2005 {published data only}
  • Jellema P, van der RN, van der Windt DA, van Tulder MW, van der Horst HE, Stalman WA, et al. Low back pain in general practice: cost-effectiveness of a minimal psychosocial intervention versus usual care. European Spine Journal 2007;16(11):1812-21.
  • Jellema P, van der Windt DA, van der Horst HE, Twisk JW, Stalman WA, Bouter LM, et al. Should treatment of (sub)acute low back pain be aimed at psychosocial prognostic factors? Cluster randomised clinical trial in general practice. BMJ 2005;331(7508):84.
Kennedy 2001 {published data only}
  • Kennedy T, Jones R, Darnley S, Seed P, Wessely S, Chalder T, et al. Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial. BMJ 2005;331(7514):435.
  • Kennedy TM, Chalder T, McCrone P, Darnley S, Knapp M, Jones RH, et al. Cognitive behavioural therapy in addition to antispasmodic therapy for irritable bowel syndrome in primary care: randomised controlled trial. Health Technology Assessment (Winchester, England) 2001;10(19):1-67.
  • McCrone P, Knapp M, Kennedy T, Seed P, Jones R, Darnley S, et al. Cost-effectiveness of cognitive behaviour therapy in addition to mebeverine for irritable bowel syndrome. European Journal of Gastroenterology & Hepatology 2008;20(4):255-63.
Klapow 2001 {published data only}
  • Klapow JC, Schmidt SM, Taylor LA, Roller P, Li Q, Calhoun JW, et al. Symptom management in older primary care patients: feasibility of an experimental, written self-disclosure protocol. Annals of Internal Medicine 2001;134(9 Pt 2):905-11.
Leonhardt 2008 {published data only}
  • Leonhardt C, Keller S, Chenot JF, Luckmann J, Basler HD, Wegscheider K, et al. TTM-based motivational counselling does not increase physical activity of low back pain patients in a primary care setting--A cluster-randomized controlled trial. Patient Education and Counseling 2008;70(1):50-60.
Lidbeck 1997 {published data only}
Lofvander 2002 {published data only}
  • Lofvander M. Cognitive-behavioural treatment of chronic pain in primary care: a three-year follow-up. European Journal of General Practice 2002;8:151-8.
Magallon 2008 {published data only}
  • Magallon R, Gili M, Moreno S, Bauza N, Garcia-Campayo J, Roca M, et al. Cognitive-behaviour therapy for patients with Abridged Somatization Disorder (SSI 4,6) in primary care: a randomized, controlled study [trial protocol]. BMC Psychiatry 2008; Vol. 8:47.
Margalit 2008 {published data only}
Martin 2007 {published data only}
  • Martin A, Rauh E, Fichter M, Rief W, Martin A, Rauh E, et al. A one-session treatment for patients suffering from medically unexplained symptoms in primary care: a randomized clinical trial. Psychosomatics 2007;48(4):294-303.
McLeod 1997 {published data only}
Pols 2008 {published data only}
  • Pols RG, Battersby MW, Pols RG, Battersby MW. Coordinated care in the management of patients with unexplained physical symptoms: depression is a key issue. Medical Journal of Australia 2008;188(12 Suppl):S133-7.
Ridsdale 2001 {published data only}
  • Chisholm D, Godfrey E, Ridsdale L, Chalder T, King M, Seed P, et al. Chronic fatigue in general practice: Economic evaluation of counselling versus cognitive behaviour therapy. The British Journal of General Practice 2001;51(462):15-8.
  • Ridsdale L, Darbishire L, Seed PT. Is graded exercise better than cognitive behaviour therapy for fatigue? A UK randomized trial in primary care. Psychological Medicine 2004;34(1):37-49.
  • Ridsdale L, Godfrey E, Chalder T, Seed P, King M, Wallace P, et al. Chronic fatigue in general practice: is counselling as good as cognitive behaviour therapy? A UK randomised trial. The British Journal of General Practice 2001;51(462):19-24.
Schade 2011 {published data only}
  • Schade N, Torres P, Beyebach M. Cost-efficiency of a brief family intervention for somatoform patients in primary care. Families, Systems, & Health 2011;29(3):197-205.
Schaefert 2011 {published data only (unpublished sought but not used)}
  • Schaefert R, Kaufmann C, Bölter R, Faber R, Wild B, Szecseny J, et al. Somatoforme Syndromes in general practice [Somatoforme Syndrome in der Hausartzpraxis]. Psychotherapeut 2011;56:315-24.
Schilte 2001 {published data only}
  • Schilte AF, Portegijs PJ, Blankenstein AH, Der Horst HE, Latour MB, van Eijk JT, et al. Randomised controlled trial of disclosure of emotionally important events in somatisation in primary care. BMJ 2001;323(7304):86.
Smith 2006 {published data only}
Smith 2009 {published data only}
Sumathipala 2008 {published data only}
  • Sumathipala A, Hewege S, Hanwella R, Mann AH. Randomized controlled trial of cognitive behaviour therapy for repeated consultations for medically unexplained complaints: a feasibility study in Sri Lanka. Psychological Medicine 2000;30(4):747-57.
  • Sumathipala A, Siribaddana S, Abeysingha MR, De Silva P, Dewey M, Prince M, et al. Cognitive-behavioural therapy v. structured care for medically unexplained symptoms: randomised controlled trial. British Journal of Psychiatry 2008;193(1):51-9.
van Bokhoven 2009 {published data only}
  • Van Bokhoven L, Bindels P, Dinant G, Grol R, Koch H, Van Der Weijden T. The diagnostic approach of early stage unexplained complaints [abstract]. Journal of Psychosomatic Research [abstracts of the 15th Annual Meeting of the European Association for Consultation-Liaison Psychiatry and Psychosomatics, EACLPP and 29th European Conference on Psychosomatic Research, ECPR; 2012 Jun 27-30; Aarhus Denmark] 2012;72(6):505.
  • van Bokhoven MA, Koch H, van der WT, Grol RP, Kester AD, Rinkens PE, et al. Influence of watchful waiting on satisfaction and anxiety among patients seeking care for unexplained complaints. Annals of Family Medicine 2009;7(2):112-20.
  • van Bokhoven MA, Koch H, van der Weijden T, Weekers Muyres AH, Bindels PJ, Grol RP. The effect of watchful waiting compared to immediate test ordering instructions on general practitioners' blood test ordering behaviour for patients with unexplained complaints; a randomized clinical trial. Implementation Science 2012;7:29.
van der Horst 1997 {published data only}
  • van der Horst HE. Irritable Bowel Syndrome in General Practice, how effective is patient education and counselling?. Amsterdam: PhD Thesis, Vrije Universiteit Amsterdam, 1997.

Additional references

  1. References to studies included in this review
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