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Randomized Controlled Trial
. 2007 Dec:191:536-42.
doi: 10.1192/bjp.bp.107.040683.

Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms

Richard Morriss  1 , Christopher Dowrick, Peter Salmon, Sarah Peters, Graham Dunn, Anne Rogers, Barry Lewis, Huw Charles-Jones, Judith Hogg, Rebecca Clifford, Christine Rigby, Linda Gask
Affiliations
Randomized Controlled Trial

Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms

Richard Morriss et al. Br J Psychiatry. 2007 Dec.

Abstract

Background: Reattribution is frequently taught to general practitioners (GPs) as a structured consultation that provides a psychological explanation for medically unexplained symptoms.

Aims: To determine if practice-based training of GPs in reattribution changes doctor-patient communication, thereby improving outcomes in patients with medically unexplained symptoms of 3 months' duration.

Method: Cluster randomised controlled trial in 16 practices, 74 GPs and 141 patients with medically unexplained symptoms of 6 hours of reattribution training v. treatment as usual.

Results: With training, the proportion of consultations mostly consistent with reattribution increased (31 v. 2%, P=0.002). Training was associated with decreased quality of life (health thermometer difference -0.9, 95% CI -1.6 to -0.1; P=0.027) with no other effects on patient outcome or health contacts.

Conclusions: Practice-based training in reattribution changed doctor-patient communication without improving outcome of patients with medically unexplained symptoms.

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Comment in

  • Reattribution for medically unexplained symptoms.
    van Ravesteijn HJ, Lucassen PL, olde Hartman TC. van Ravesteijn HJ, et al. Br J Psychiatry. 2008 Apr;192(4):314-5; author reply 315. doi: 10.1192/bjp.192.4.314a. Br J Psychiatry. 2008. PMID: 18379002 No abstract available.

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