Dataset Information

Diagnosis of somatisation: effect of an educational intervention in a cluster randomised controlled trial.

ABSTRACT:

Background

Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often goes unrecognised. Non-recognition may lead to ineffective treatment, risk of iatrogenic harm, and excessive use of healthcare services.

Aim

To examine the effect of training on diagnosis of somatisation in routine clinical practice by general practitioners (GPs).

Design of study

Cluster randomised controlled trial, with practices as the randomisation unit.

Setting

Twenty-seven general practices (with a total of 43 GPs) in Vejle County, Denmark.

Method

Intervention consisted of a multifaceted training programme (the TERM [The Extended Reattribution and Management] model). Patients were enrolled consecutively over a period of 13 working days. Psychiatric morbidity was assessed by means of a screening questionnaire. GPs categorised their diagnoses in another questionnaire. The primary outcome was GP diagnosis of somatisation and agreement with the screening questionnaire.

Results

GPs diagnosed somatisation less frequently than had previously been observed, but there was substantial variation between GPs. The difference between groups in the number of diagnoses of somatisation failed to reach the 5% significance (P = 0.094). However, the rate of diagnoses of medically unexplained physical symptoms was twice as high in the intervention group as in the control group (7.7% and 3.9%, respectively, P = 0.007). Examination of the agreement between GPs' diagnoses and the screening questionnaire revealed no significant difference between groups.

Conclusion

Brief training increased GPs' awareness of medically unexplained physical symptoms. Diagnostic accuracy according to a screening questionnaire remained unaffected but was difficult to evaluate, as there is no agreement on a gold standard for somatisation in general practice.

SUBMITTER: Rosendal M

PROVIDER: S-EPMC1314743 | biostudies-literature | 2003 Dec

REPOSITORIES: biostudies-literature

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Publications

Diagnosis of somatisation: effect of an educational intervention in a cluster randomised controlled trial.

Rosendal Marianne M Bro Flemming F Fink Per P Christensen Kaj Sparle KS Olesen Frede F

The British journal of general practice : the journal of the Royal College of General Practitioners 20031201 497

<h4>Background</h4>Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often goes unrecognised. Non-recognition may lead to ineffective treatment, risk of iatrogenic harm, and excessive use of healthcare services.<h4>Aim</h4>To examine the effect of training on diagnosis of somatisation in routine clinical practice by general practitioners (GPs).<h4>Design of study</h4>Cluster randomised controlled trial, with practices as the randomisation unit.<h4>Setting ...[more]

PMID: 14960214

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Dataset Information

Diagnosis of somatisation: effect of an educational intervention in a cluster randomised controlled trial.

Background

Aim

Design of study

Setting

Method

Results

Conclusion

Publications

Diagnosis of somatisation: effect of an educational intervention in a cluster randomised controlled trial.

Similar Datasets

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