Somatizing distress: hospital treatment of psychiatric co-morbidity and the limitations of biomedicine.
Analysis reveals that treatment of psychiatric co-morbidity in hospitals has a somatizing effect. The patients typically have long, costly hospital stays marked by numerous nonpsychiatric consultations. When consulted, psychiatrists are constrained by their role within the hospital social system and tend to employ somatopsychic approaches which are compatible with the orientation of their physician consultees. Case studies illustrate the inadequacy of these treatment modes and highlight the significance of social and economic problems as etiologic factors in psychiatric co-morbidity. Applying a critical approach from the field of medical anthropology, we argue that the ultimate solution to many patients' problems lies outside of the realm of biomedicine and depends on changes in social policies. Thus, the limitations of biomedicine are seen as due both to its predisposition toward somatic treatment and to larger social forces which cause its practitioners to be part of the problem rather than part of the solution.
Padgett
D
D
School of Social Work, New York University, NY 10003.
Johnson
T M
TM
D000293:Adolescent; D015897:Comorbidity; D005260:Female; D006761:Hospitals; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology; D011247:Pregnancy; D011570:Psychiatry; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*