Diagnosis of somatising patients; Is there agreement between health care professional?
Before treating patients setting a proper diagnosis is essential. In somatising patients this is difficult; these patients experience physical complaints without having a specific anatomic deficit. Patients search for a solution within the health care often visiting several health care professional. The purpose of this study was to investigate the way health care professionals diagnose these patients and to analyze the agreement between health care professionals. The study population existed of 40 psychologists,77 doctors and paramedics and 115 psychology students. They were shown four video presentations of patients with headache; with an anxious-depressive presentation, a neutralpresentation, an adequate presentation in which the headache resolved after sufficient self-management andwith a theatrical presentation with a lot of somatic complaints.Diagnoses were classified in five domains: a DSMIV diagnosis, a medical-somatic diagnosis, describing a mechanism that could explain the complaints such as ‘stress’, just describing the complaints such as ‘a headache’ or no diagnosis at all. Many different diagnoses were used by the different health care professionals namely; 70 at patient one, 62 at patient two, 36 at patient three and 63 at patient four. In the somatising patient’s significant differences were found between the health care professionals and students. Doctors and (para)medics set a lot more medical diagnoses in patients who somatize and psychologists and psychology students more DSM IV diagnosis. In this study we found a lot of variation between different health care professional and students especially when somatic complains are combined with psychological problems. When these health care professionals are working together in health care the must be aware of these differences in language especially within multidisciplinary teams.