This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Elderkin-Thompson, V. Articles by Waitzkin, H. Search for Related Content PubMed Articles by Elderkin-Thompson, V. Articles by Waitzkin, H. Social Bookmarking                         What's this?

Narratives of Somatizing and Non somatizing Patients in a Primary Care Setting

University of California, Irvine, USA

Roxane Cohen Silver

University of California, Irvine, USA

Howard Waitzkin

University of New Mexico, Albuquerque, USA

Somatizing patients, who comprise approximately 20 percent of the primary care population, often present physicians with recurrent but confusing combinations of symptoms without organic explanations. Illness narratives presented during initial medical encounters with primary care physicians were examined qualitatively to determine if the narrative structure, chronological development of symptoms and temporal frame differed between somatizing and non-somatizing patients. Following a structured interview to identify somatization tendency and co-morbidities of depression and post-traumatic stress disorder, 116 patients' encounters with primary care physicians were video-recorded and transcribed. Somatizers demonstrated a narrative structure that was similar to that of non-somatizing patients, but they used a thematic rather than a chronological development of symptoms and they did not convey a clear time frame. Somatizing patients with a co-morbid psychological condition focused on concrete physical sensations, were unable to provide contextual history or chronological organization, and did not develop a temporal frame. The narratives of somatizing and non-somatizing patients differed sufficiently to warrant further research for use as a clinical aid in the diagnosis of somatization.

Key Words: communication • illnesss story, narrative • primary care, somatization

Journal of Health Psychology, Vol. 3, No. 3, 407-428 (1998)
DOI: 10.1177/135910539800300309


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?