title: Why reassurance fails in patients with unexplained symptoms--an experimental investigation of remembered probabilities.
abstract: BACKGROUND
  Providing reassurance is one of physicians' most frequently used verbal interventions. However, medical reassurance can fail or even have negative effects. This is frequently the case in patients with medically unexplained symptoms. It is hypothesized that these patients are more likely than patients from other groups to incorrectly recall the likelihoods of medical explanations provided by doctors.
  
  
  RESULTS
  Thirty-three patients with medically unexplained symptoms, 22 patients with major depression, and 30 healthy controls listened to an audiotaped medical report, as well as to two control reports. After listening to the reports, participants were asked to rate what the doctor thinks the likelihood is that the complaints are caused by a specific medical condition. Although the doctor rejected most of the medical explanations for the symptoms in his verbal report, the patients with medically unexplained complaints remembered a higher likelihood for medical explanations for their symptoms. No differences were found between patients in the other groups, and for the control conditions. When asked to imagine that the reports were applicable to themselves, patients with multiple medical complaints reported more concerns about their health state than individuals in the other groups.
  
  
  CONCLUSIONS
  Physicians should be aware that patients with medically unexplained symptoms recall the likelihood of medical causes for their complaints incorrectly. Therefore, physicians should verify correct understanding by using check-back questions and asking for summaries, to improve the effect of reassurance.
authors.affiliation: Department of Clinical Psychology, University of Marburg, Marburg, Germany. rief@staff.uni-marburg.de
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
authors.forename: Andrea Maren
authors.initials: AM
authors.lastname: Heitmüller
authors.forename: Katja
authors.initials: K
authors.lastname: Reisberg
authors.forename: Heinz
authors.initials: H
authors.lastname: Rüddel
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008499:Medical Records; D011939:Mental Recall; D010565:Persuasive Communication; D010817:Physician-Patient Relations; D011320:Primary Health Care; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires; D013637:Tape Recording