[Psychiatric consultation at a general hospital (II): The problem of the patient with a somatic disorder].
The article presents the difficulties of the psychiatric consultation with patients having somatic complaints. A model of evaluation and intervention is proposed in which the link between the somatic complaint and the doctor-patient relationship is emphasized. A closer look at the manifest request for consultation often leads to interpreting the consultation as a symptom of the patient's relationship to his doctor. The consultation is often a confrontation with the hidden conflict of the patient embedded in his symptom, but actualized with his referring doctor. The focus is on the patient as the agent of his trouble. A clinical vignette is presented.
Laperrière
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Département de Psychiatrie, Hôpital Laval, Sainte-Foy, Québec.
Sirois
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D000328:Adult; D000787:Angina Pectoris / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology; D001026:Coronary Artery Bypass / Q000523:psychology; D003327:Coronary Disease / Q000601:surgery; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D011183:Postoperative Complications / Q000523:psychology; D011602:Psychophysiologic Disorders / Q000523:psychology*; D011613:Psychotherapy; D012017:Referral and Consultation; D013001:Somatoform Disorders / Q000523:psychology*
Consultations psychiatriques dans un hôpital général. (II): La problematique du somatisant.