An approach to the patient with multiple physical symptoms or chronic disease.
Doctors diagnose and treat disease; illness is the experience of, and response to, a disease by patients and the people in their lives. Discrepancies between disease and illness (eg, adjustment to the sick role, treatment-related difficulties, denial of medical illness, and psychiatric comorbidity) are prevalent, as are somatoform disorders and other conditions in which patients are invested in being understood as medically ill. This article reviews suggestions for physicians' responses to these patients and their dilemmas.
New York State Psychiatric Institute, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY 10032, USA.
Janna S
JS
Gordon-Elliott
Philip R
PR
Muskin
D000328:Adult; D002908:Chronic Disease; D005162:Factitious Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy