Volume 3, Number 2, 177-190, DOI: 10.1007/BF02596128

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Somatization in primary care
Patients with unexplained and vexing medical complaints

Craig Kaplan, Mack Lipkin and Geoffrey H. Gordon

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Abstract

Somatizing patients experience or express emotional discomfort and psychosocial distress as physical symptoms. Somatization occurs in a broad spectrum of illnesses, in association with a wide variety of mental disorders, including depression, anxiety, and the somatoform disorders. Primary care providers must detect and treat these patients. Diagnosis is based on positive criteria. Care rests upon conservative medical management and evaluation; a physician-patient relationship based on acceptance, caring, and trust; reinforcement of positive behaviors and elimination of destructive ones; and the gradual use of the relationship to promote healthy relating in the patient.
Received from the Division of General Internal Medicine, University of Kentucky and VA Medical Center, Lexington, Kentucky; the Division of Primary Care. Department of Medicine, New York University School of Medicine, New York, New York; and the Ambulatory and Medical Services, Portland VA Health Sciences University, Portland, Oregon.

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