Management of somatisers in primary care: are family doctors motivated?

Abstract

Objective: The aim of this paper is to assess the attitudes of Spanish general practitioners towards somatisers and the degree of involvement that family doctors are ready to adopt in the care of these patients.

Method: A postal questionnaire on attitudes was sent to a representative sample (n = 135) of general practitioners from two health districts of the region of Aragon. Seventy (51.8%) of them returned usable questionnaires.

Results: Most of the general practitioners were interested in the treatment of somatisers and considered that they should be treated at primary care level. However, when specific treatment tasks were proposed, they only accepted to act as a filter to specialised care and to care for patients with chronic functional syndromes. Additionally, they refuse to detect presenting somatisers, to prescribe psychotropic drugs or offer any psychological approach, and to avoid reinforcing abnormal illness behaviour in these patients and their families. These findings can be explained because the main emotions somatisers produce in doctors are frustration and anger.

Conclusions: Family doctors need a lot more help, education and support in the management of somatisers, and psychiatrists need to provide it. Any management program for the treatment of somatisers in primary care should include methods to modify general practitioners' attitudes towards these patients.