title: Approach to the patient with multiple somatic symptoms.
abstract: Primary care providers play a crucial role in the recognition and appropriate treatment of patients with multiple somatic complaints. Both the number of somatic symptoms and the persistence of symptoms are associated with co-occurring depression or anxiety disorders. It can be challenging to simultaneously address possible medical causes for physical symptoms while also considering an associated psychiatric diagnosis. In this article, strategies to improve the care and outcomes among these patients are described, including collaboration, education about the interaction between psychosocial stressors and somatic symptoms, regularly scheduled visits, focus on improving functional status, and evidence-based treatment of depression and anxiety.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 359911, 325 Ninth Avenue, Seattle, WA 98104, USA. Electronic address: croicu@u.washington.edu.
authors.forename: Carmen
authors.initials: C
authors.lastname: Croicu
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 359911, 325 Ninth Avenue, Seattle, WA 98104, USA.
authors.forename: Lydia
authors.initials: L
authors.lastname: Chwastiak
authors.affiliation: Division of Health Services and Psychiatric Epidemiology, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, 1959 Northeast Pacific, Seattle, WA 98195, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Katon
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015984:Causality; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008487:Medical History Taking; D010348:Patient Care Team; D010808:Physical Examination; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012017:Referral and Consultation; D012307:Risk Factors; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents
keywords: Anxiety; Collaborative care; Depression; Somatic symptoms; Somatization