scholarly journals The role of attachment in medically unexplained symptoms and long-term illness

2015 ◽  
Vol 21 (3) ◽  
pp. 167-174 ◽  
Author(s):  
Gwen Adshead ◽  
Elspeth Guthrie
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Illness ◽  
Developmental Model ◽  
Attachment Insecurity ◽  
Physical Conditions ◽  
Medically Unexplained ◽  
Unexplained Symptoms

SummaryIn this article, we explore the role of attachment in the development of medically unexplained symptoms (MUS) and response to physical illness. We review the evidence that attachment insecurity is common in people with different forms of MUS and certain long-term physical conditions. We discuss a possible developmental model for understanding how MUS develop. We conclude with discussion of potential therapies and implications for services.

Liaison Psychiatry and Organic Illness

2014 ◽  
Author(s):  
Andrew Horton ◽  
Mark Broadhurst
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Symptoms ◽  
Mental Illnesses ◽  
Working Relationships ◽  
Liaison Psychiatry ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
The Uk

Liaison psychiatry is a subspecialty of psychiatry which involves the diag­nosis, treatment, and management of psychiatric illness in patients who have physical illnesses or present with physical symptoms. There is considerable overlap between psychiatric and medical condi­tions which requires close working relationships with medical colleagues. Liaison psychiatry is a fascinating area where the range of psychiatric presentations is wide, every case is different, and there is opportunity to keep up to date with medicine as it evolves. Within the UK there are different models practiced in different areas, ranging from assessment and signposting services to services with provi­sion for long-term outpatient follow-up. There is increasing interest in the provision of liaison services in primary care because of the challenges faced by GPs in treating patients with medically unexplained symptoms. Another driver is the hugely increased morbidity and mortality rates seen in patients with co-morbid physical and mental illnesses who receive the majority of their treatment in secondary care.

Liaison psychiatry

2019 ◽  
pp. 839-880
Author(s):  
David Semple ◽  
Roger Smyth
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Illness ◽  
Anxiety Symptoms ◽  
Differential Diagnoses ◽  
Psychotic Symptoms ◽  
Liaison Psychiatry ◽  
Medically Unexplained ◽  
Medical Population ◽  
Self Harm ◽  
Unexplained Symptoms

This chapter concerns liaison psychiatry and the assessment and management of psychiatric and psychological illnesses in the general medical population. It covers the 12 most common referral types, assessment of depressive and anxiety symptoms, psychotic symptoms and confusion, depression in physical illness, delirium, and management after self-harm. Focusing on capacity and consent, as well as differential diagnoses and potential management principles for medically unexplained symptoms, it covers the basis of working as a psychiatrist in a hospital.

scholarly journals The role of emotion in psychotherapeutic change for medically unexplained symptoms

2017 ◽  
Vol 29 (1) ◽  
pp. 86-98 ◽  
Author(s):  
Joel M. Town ◽  
Victoria Lomax ◽  
Allan A. Abbass ◽  
Gillian Hardy
Keyword(s):  
Medically Unexplained Symptoms ◽  
Psychotherapeutic Change ◽  
Medically Unexplained ◽  
Unexplained Symptoms

scholarly journals IAPT under the microscope

2018 ◽  
Vol 23 (9) ◽  
pp. 1131-1135 ◽  
Author(s):  
David F Marks
Keyword(s):  
Recovery Rate ◽  
Medically Unexplained Symptoms ◽  
Long Term Conditions ◽  
Recovery Rates ◽  
Expert Review ◽  
Psychological Therapies ◽  
Independent Expert ◽  
Medically Unexplained ◽  
Unexplained Symptoms

England’s flagship ‘Improving Access to Psychological Therapies’ (IAPT) service has cost around £1 billion yet Scott’s (2018a) study suggests that only 9.2% of IAPT patients recover. This leaves an enormous gap of 40.8% between the observed recovery rate and IAPT’s claimed recovery rate of 50.0%. The spotlight is on patients with ‘medically unexplained symptoms’ (MUS) and ‘long-term conditions’ (LTCs) such as ‘diabetes, COPD and ME/CFS, yet there is no way of knowing whether IAPT is capable of yielding the promised rewards or English patients are being sold an expensive pup. An urgent independent expert review of IAPT recovery rates is necessary to answer this question.

Liaison psychiatry

2013 ◽  
pp. 775-818
Keyword(s):  
Medically Unexplained Symptoms ◽  
Physical Illness ◽  
Anxiety Symptoms ◽  
Psychotic Symptoms ◽  
Acute Confusional State ◽  
Liaison Psychiatry ◽  
Clinical Presentations ◽  
Medically Unexplained ◽  
Self Harm ◽  
Unexplained Symptoms

Introduction Working in the general hospital Assessment of depressive and anxiety symptoms Assessment of psychotic symptoms and confusion Assessment after self-harm Management after self-harm Depression in physical illness Acute confusional state (delirium) Capacity and consent Medically unexplained symptoms 1: introduction Medically unexplained symptoms 2: clinical presentations...

scholarly journals Extending Cognitive-Behavioural Theory and Therapy to Medically Unexplained Symptoms and Long-Term Physical Conditions: A Hybrid Transdiagnostic/Problem Specific Approach

2016 ◽  
Vol 33 (4) ◽  
pp. 172-192 ◽  
Author(s):  
Paul M. Salkovskis ◽  
James D. Gregory ◽  
Alison Sedgwick-Taylor ◽  
Julie White ◽  
Simon Opher ◽  
...  
Keyword(s):  
Belief Change ◽  
Medically Unexplained Symptoms ◽  
Long Term Conditions ◽  
Treatment Protocols ◽  
Specific Approach ◽  
Cognitive Behavioural ◽  
Wide Range ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Medically unexplained symptoms (MUS) are not only common and distressing, but are also typically poorly managed in general medical settings. Those suffering from these problems tend to incur significantly higher health costs than the general population. There are many effective treatments for different MUS; these are almost entirely based on cognitive-behavioural approaches. However, the wide range of treatment protocols tend to be ‘syndrome specific’. As such, they do not generalise well in terms of training and application, making them expensive and difficult to disseminate, suggesting the desirability of developing a transdiagnostic approach. The general basis of such a CBT grounded transdiagnostic approach is considered, and the particular need to incorporate cognitive elements of both anxiety or health anxiety (threat) and depression (loss) is highlighted. Key empirically grounded and evidence-based processes (both specific and general) previously identified as underpinning the maintenance of MUS are delineated. The way in which these can be combined in a transdiagnostic model that accounts for most MUS presentations is presented and linked to a formulation-driven transdiagnostic treatment strategy, which is described. However, the need to take more syndrome-specific issues into account in treatment is identified, suggesting that the optimum treatment may be a hybrid transdiagnostic/specific approach with formulation, shared understanding, belief change strategies, and behavioural experiments at its heart. The generalisation of such approaches to psychological problems occurring in the context of ‘long-term conditions’ is identified as a further important development that is now within reach.

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