title: A randomized controlled clinical trial of a psychosocial and communication intervention carried out by GPs for patients with medically unexplained symptoms.
abstract: BACKGROUND
  Somatizing patients are a challenge to general practitioners (GPs). A cluster randomized controlled trial was conducted to asses the effect of specific communication techniques delivered by GPs on somatizing patients' self-perceived health.
  
  
  METHODS
  Thirty-nine GPs were assigned randomly to two parallel groups. GPs in the intervention group treated somatic patients according to specific communication techniques focused on offering a physical explanation - release of hormones - and approaching sensitive topics in the patient's experience indirectly. Control GPs used the standard Goldberg reattribution technique. A total of 156 patients, aged 18-65 years, were selected randomly from a list of 468 patients with six or more active symptoms for women and four or more for men. All patients had six programmed 30-min consultations. Health-related quality of life (assessed with the 36-item Short-Form Health Survey, SF-36) and a summary utility index were used as outcome measures. Patients were interviewed at home at baseline and at 3, 8 and 12 months after the beginning of the intervention.
  
  
  RESULTS
  Patients in both groups improved in all dimensions of the SF-36. The time course of the quality of life was significantly better for the intervention group in five of the eight scales of the SF-36 (bodily pain, mental health, physical functioning, vitality, and social functioning) and in the utility index (p<0.039).
  
  
  CONCLUSIONS
  Communication techniques were found to have a clinically relevant impact on body pain. This finding, together with a trend towards better scores in the remaining scales, justifies the use of these techniques in psychosocial interventions delivered to patients with medically unexplained symptoms.
authors.affiliation: San Inazio Health Care Centre, Basque Health Service (Osakidetza), Bilbao, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Aiarzaguena
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Grandes
authors.forename: Idoia
authors.initials: I
authors.lastname: Gaminde
authors.forename: Agustín
authors.initials: A
authors.lastname: Salazar
authors.forename: Alvaro
authors.initials: A
authors.lastname: Sánchez
authors.forename: Julen
authors.initials: J
authors.lastname: Ariño
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D010821:Physicians, Family; D013001:Somatoform Disorders / Q000523:psychology*; D013030:Spain; D016896:Treatment Outcome