title: Establishing a psychosomatic clinic in a low resource setting: Process, challenges, and opportunities.
abstract: BACKGROUND
  Specialty psychosomatic clinics are a felt need in low- and middle-income countries, but its benefits and challenges have not been reported so far.
  
  
  OBJECTIVE
  To describe the process, challenges, and opportunities that we encountered in setting up a specialty psychosomatic clinic at a government medical college in South India.
  
  
  METHODS
  The biweekly psychosomatic clinic was located in the Department of Psychiatry and manned by a multimodal team. Structured questionnaires were used to evaluate all patients. All psychiatric diagnoses were made as per International Classification of Diseases-10, clinical descriptions and diagnostic guidelines. Management comprised both pharmacotherapy and psychotherapeutic interventions.
  
  
  RESULTS
  A total of 72 patients registered for services in the 1(st) year of the clinic. The mean age of the sample was 36.6 years (range 14-60 years). A median of 2 years and 19 visits to various care providers had elapsed before their visit to the clinic. The index contact was a general practitioner in the majority of cases though an overwhelming majority (95.6%) had also sought specialist care. The most common diagnostic cluster was the somatoform group of disorders (50.0%). Antidepressants were the most commonly prescribed medications (70.6%).
  
  
  CONCLUSIONS
  The specialty psychosomatic clinic provided better opportunities for a more comprehensive evaluation of people with medically unexplained symptoms and better resident training and focused inter-disciplinary research. It describes a scalable model that can be replicated in similar resource constrained settings.
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Menon
authors.affiliation: Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
authors.forename: Shijo
authors.initials: S
authors.lastname: Thomas
keywords: Challenges; clinic; medically unexplained symptoms; opportunities; psychosomatic