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Psychological approaches to somatisation in developing countries

  • Vikram Patel and Athula Sumathipala


Medically unexplained somatic complaints are among the most common clinical presentations in primary care in developing countries and they are a considerable burden for patients and the healthcare system. They are assumed to be the result of psychosocial factors, and the process by which symptoms are experienced is termed somatisation. Common mental disorders, somatoform disorders and socio-economic adversities are the major risk factors for these complaints. There is evidence suggesting that cognitive–behavioural therapy, which has proven efficacy for somatoform disorders in the developed world, can be used in developing countries with some adaptations (e.g. by simplifying the content so that it can be applied in primary care by non-specialist health practitioners; using culturally appropriate analogies; and delivering the intervention over fewer and shorter sessions). The main components of such an intervention are presented in this article.

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Psychological approaches to somatisation in developing countries

  • Vikram Patel and Athula Sumathipala
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Does Psychological Treatment Work ?

Dr A J Shishodia, SHO-Psychiatry
18 February 2006

Despite having reliable knowledge about medically unexplained disorders, the evidence base for their treatment remains poor. This paper does a wonderful job in describing psychological approaches to somatisation in developing countries, but several points warrant further consideration.

1. There are very few papers that give any form of evidence relating to psychological treatments in the developing countries.2. There are important cultural issues attached to somatisation. Even today in developing countries people feel predjuiced about seeing a psychiatrist for any form of treatment.3. Resources are often too scarce to think about any form of psychological approach in developing countries even if people do make it to the psychiatrist.4. There may be evidence to show that psycholgical treatment works in the developed countries but the evidence base for this varies from being excellent to poor.5. What works in developed countries will not necessarily work in developing countries.6. There may be a long way to go before such treatments find strong support in thedeveloping countries.

Dr Ashok Shishodia SHO West London Mental Health Trust Dr Pooja Tandon SHO West London Mental Health Trust
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