KB a very pleasant lady aged 79 was interviewed in her home during my GP placement. Her presenting complaint is that she has not left the house in six weeks secondary to pain in her legs, and immobility on a background history of chronic pain (diagnosed with somatoform disorder) in legs and arms since age 16.
History presenting complaint- No recent medical illness, but reports a decrease in sleep and a reduction in mobility secondary to pain over last 6 weeks.
Personal history / Social history- Lives with her younger sister at present whom is very good to her. They both live in a 2 storey house and uses a motor scooter to get around outside She walks independently with one stick and manages to get up the stairs using …show more content…
3 The difficulty in managing these patients is that they are often examined thoroughly for a medical cause initially and when none is found, patients can often feel dismissed when the discussion of psychological intervention arises.1
This presentation to the General practitioner initially with somatoform disorder and medically unexplained symptoms can present lots of challenges for the patient and for the GP alike. 4The GP plays an essential role in the successful management of these conditions in order to not over use the health services in over investigating unexplained medical symptoms unnecessarily and in referring appropriately and sensitively for psychological help.5 As the GP is often the first port of call, it is essential that the therapeutic relationship between the doctor and patient withstand these challenges.1 Studies have also shown that if somatoform disorder were managed more effectively in primary care, then a huge reduction in cost to the health service via an improved utilisation of health care system would be