Primary care clinicians treat patients with medically unexplained symptoms: A randomized controlled trial
Open accessAbstract
Objective There is no proven primary care treatment for patients with medically unexplained symptoms (MUS). We hypothesized that a long-term, multidimensional intervention by primary care providers would improve MUS patients' mental health.Design Clinical trial.Setting HMO in Lansing, MI.Participants Patients from 18 to 65 years old with 2 consecutive years of high utilization were identified as having MUS by a reliable chart rating procedure; 206 subjects were randomized and 200 completed the study.Intervention From May 2000 to January 2003, 4 primary care clinicians deployed a 12-month intervention consisting of cognitive-behavioral, pharmacological, and other treatment modalities. A behaviorally defined patient-centered method was used by clinicians to facilitate this treatment and the provider-patient relationship.Main outcome measure The primary endpoint was an improvement from baseline to 12 months of 4 or more points on the Mental Component Summary of the SF-36.Results Two hundred patients averaged 13.6 visits for the year preceding study. The average age was 47.7 years and 79.1% were females. Using intent to treat, 48 treatment and 34 control patients improved (odds ratio [OR]=1.92, 95% confidence interval [CI]: 1.08 to 3.40; P=.02). The relative benefit (relative "risk" for improving) was 1.47 (CI: 1.05 to 2.07), and the number needed to treat was 6.4 (95% CI: 0.89 to 11.89). The following baseline measures predicted improvement: severe mental dysfunction (P<.001), severe body pain (P=.039), nonsevere physical dysfunction (P=.003), and at least 16 years of education (P=.022); c-statistic=0.75.Conclusion The first multidimensional intervention by primary care clinicians led to clinically significant improvement in MUS patients.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Only two studies have explicitly considered repeated service use in MUS, and only one identified those frequently attending for 2 years.
“Only two studies have explicitly considered repeated service use in MUS, however, and only one identified those frequently attending for 2 years. 16,17”
From Cognitive behaviour therapy for long-term frequent attenders in primary care: A feasibility case series and treatment development study (2016) · cites this paper as [17]
The Subject Identification section says the study identified patients with MUS who had at least eight visits per year for the preceding two years. The paper does not establish that only two studies considered repeated service use in MUS, or that this was the only one to identify frequent attenders over two years. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe remaining six studies were randomized by patient.
“and the remaining six were randomized by patient (Brown 2001; McLean 2004; Smith 2006; Song 2005; Sorlie 2007; Wolf 2008).”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Smith 2006
In Smith 2006, the intervention group was more likely to have improved SF-36 mental component summary scores after 12 months than control patients.
“Similarly, the intervention group in Smith 2006 were more likely to have improved SF‐36 mental component summary and physical disability scores after 12 months than control patients.”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Smith 2006
In Smith 2006, the intervention group was more likely to have improved physical disability scores after 12 months than control patients.
“Similarly, the intervention group in Smith 2006 were more likely to have improved SF‐36 mental component summary and physical disability scores after 12 months than control patients.”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Smith 2006
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.51.6.1173 · Cited by 91,542 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2022) · doi:10.1176/appi.books.9780890425787 · Cited by 23,476 · see citing works
SF-36 health survey: Manual and interpretation guide
Ware, J. (2003) · Medical Entomology and Zoology · Cited by 11,424 · see citing works
(1994) · Medical Entomology and Zoology · Cited by 4,156 · see citing works
State-Trait Anxiety Inventory for Adults
Spielberger, C. D. (2012) · PsycTESTS Dataset · doi:10.1037/t06496-000 · Cited by 3,479 · see citing works
Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study
Spitzer, R. L. (1994) · JAMA · doi:10.1001/jama.272.22.1749 · Cited by 2,648 · see citing works
Manual for the state-trait anxiety inventory (form Y) : "self-evaluation questionnaire"
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970) · Consulting Psychologists Press eBooks · Cited by 2,352 · see citing works
Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care: The PRIME-MD 1000 Study
Spitzer, R. L. (1994) · JAMA · doi:10.1001/jama.1994.03520220043029 · Cited by 1,873 · see citing works
Horrocks, S., Anderson, E., & Salisbury, C. (2002) · BMJ · doi:10.1136/bmj.324.7341.819 · Cited by 1,235 · see citing works
Turner‐Bowker, D. M., DeRosa, M., & Ware, J. E. (2008) · eScholarship@UMassChan · Cited by 954 · see citing works
Medically Unexplained Physical Symptoms, Anxiety, and Depression: A Meta-Analytic Review
Henningsen, P., Zimmermann, T., & Sattel, H. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000075977.90337.e7 · Cited by 829 · see citing works
Stepped Collaborative Care for Primary Care Patients With Persistent Symptoms of Depression
Katon, W. J., Korff, M. V., Lin, E., Simon, G., Walker, E., Unützer, J., Bush, T. M., Russo, J. E., & Ludman, E. J. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.12.1109 · Cited by 658 · see citing works
Somatic presentation of DSM-III psychiatric disorders in primary care
Bridges, K. W., & Goldberg, D. P. (1985) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(85)90064-9 · Cited by 534 · see citing works
Cognitive Behavior Therapy for Hypochondriasis
BARSKY, A. J., & Ahern, D. K. (2004) · JAMA · doi:10.1001/jama.291.12.1464 · Cited by 313 · see citing works
Achieving Guidelines for the Treatment of Depression in Primary Care
Lin, E. H. B., Katon, W. J., Simon, G. E., Korff, M. V., Bush, T. M., Rutter, C. M., Saunders, K. W., & Walker, A. (1997) · Medical Care · doi:10.1097/00005650-199708000-00008 · Cited by 228 · see citing works
Smith, R. C., Lyles, J. S., Mettler, J., Stoffelmayr, B. E., Van Egeren, L. F., Marshall, A. A., Gardiner, J. C., Maduschke, K. M., Stanley, J. M., Osborn, G. G., et al. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-2-199801150-00008 · Cited by 228 · see citing works
Self-citationEscobar, J. I., Waitzkin, H. B., Silver, R. C., Gara, M. A., & Holman, A. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199807000-00012 · Cited by 203 · see citing works
Current Concepts of Somatization: Research and Clinical Perspectives
Kirmayer, L. J., & Robbins, J. M. (1991) · Medical Entomology and Zoology · Cited by 197 · see citing works
Self-report disability in an international primary care study of psychological illness
Korff, M. V., Üstün, T. B., Ormel, J., Kaplan, I., & Simon, G. E. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(95)00512-9 · Cited by 161 · see citing works
Treating patients with medically unexplained symptoms in primary care
Smith, R. C., Lein, C., Collins, C., Lyles, J. S., Given, B., Dwamena, F. C., Coffey, J., Hodges, A., Gardiner, J. C., Goddeeris, J., et al. (2003) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2003.20815.x · Cited by 123 · see citing works
Self-citationSmith, R. C., Lyles, J. S., Mettler, J., Marshall, A. A., Egeren, L. F. V., Stöffelmayr, B. E., Osborn, G. G., & Shebroe, V. (1995) · Academic Medicine · doi:10.1097/00001888-199508000-00019 · Cited by 121 · see citing works
Self-citationExploration of DSM-IV Criteria in Primary Care Patients With Medically Unexplained Symptoms
Smith, R. C., Gardiner, J. C., Lyles, J. S., Sirbu, C. M., Dwamena, F. C., Hodges, A., Collins, C. E., Lein, C., Given, C. W., Given, B. A., et al. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000149279.10978.3e · Cited by 118 · see citing works
Self-citationLabbate, L. A., Croft, H. A., & Oleshansky, M. A. (2003) · PubMed · Cited by 113 · see citing works
Somatisation disorder in primary care
Escobar, J. I., Gara, M. A., Silver, R. C., Waitzkin, H. B., Holman, A., & Compton, W. M. (1998) · The British Journal of Psychiatry · doi:10.1192/bjp.173.3.262 · Cited by 110 · see citing works
Patient-Centered Interviewing: An Evidence-Based Method
Smith, R. C. (2002) · Medical Entomology and Zoology · Cited by 90 · see citing works
Self-citationSomatization disorder in a family practice.
deGruy, F. V., Columbia, L., & Dickinson, W. P. (1987) · PubMed · Cited by 73 · see citing works
Lyles, J. S., Hodges, A., Collins, C. E., Lein, C., Given, C. W., Given, B. A., D’Mello, D. A., Osborn, G. G., Goddeeris, J. H., Gardiner, J. C., et al. (2003) · General Hospital Psychiatry · doi:10.1016/s0163-8343(02)00288-8 · Cited by 54 · see citing works
Self-citationFraming and Designing the Cost Effectiveness Analysis
Torrance, G. W., Siegel, J. E., & Luce, B. R. (1996) · doi:10.1093/oso/9780195108248.003.0003 · Cited by 46 · see citing works
A Method for Rating Charts to Identify and Classify Patients with Medically Unexplained Symptoms
Smith, R. C., Hage-Korban, E., Kanj, M., Haddad, R. I., Lyles, J. S., Lein, C., Gardiner, J. C., Hodges, A., Dwamena, F. C., Coffey, J. B., et al. (2003) · Psychotherapy and Psychosomatics · doi:10.1159/000074438 · Cited by 28 · see citing works
Self-citationThe Psychosomatic Symptom Checklist revisited: Reliability and validity in a chronic pain population
Chibnall, J. T., & Tait, R. C. (1989) · Journal of Behavioral Medicine · doi:10.1007/bf00844873 · Cited by 28 · see citing works
Cognitive behavioural therapies in the treatment of functional somatic symptoms
Sharpe, M. (1995) · doi:10.1093/oso/9780192624994.003.0007 · Cited by 26 · see citing works
Patient-Centered Interviewing: An Evidence-Based Method. 2nd ed.
Murcko, A. C. (2002) · Clinical Nurse Specialist · doi:10.1097/00002800-200211000-00019 · Cited by 25 · see citing works
Illness and Satisfaction With Medical Care
Hall, J. A., Roter, D., & Milburn, M. A. (1999) · Current Directions in Psychological Science · doi:10.1111/1467-8721.00023 · Cited by 17 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Kroenke K. The interface between physical and psychological symptoms. Primary Care Companion. J Clin Psychiatry. 2003;5(Suppl 7):11–8.
Cited by
Sorted by citations
Interventions for providers to promote a patient-centred approach in clinical consultations
Dwamena, F., Holmes-Rovner, M., Gaulden, C. M., Jorgenson, S., Sadigh, G., Sikorskii, A., Lewin, S., Smith, R. C., Coffey, J., Olomu, A., et al. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003267.pub2 · Cited by 1,227 · see citing works
Self-citationWoltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. S. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.11111616 · Cited by 603 · see citing works
Efficacy of treatment for somatoform disorders: a review of randomized controlled trials
Kroenke, K. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31815b00c4 · Cited by 450 · see citing works
van Dessel, N., den Boeft, M., van der Wouden, J. C., Kleinstäuber, M., Leone, S. S., Terluin, B., Numans, M. E., van der Horst, H. E., & van Marwijk, H. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011142.pub2 · Cited by 302 · see citing works
Polusny, M. A., Kehle, S. M., Nelson, N. W., Erbes, C. R., Arbisi, P. A., & THURAS, P. D. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.172 · Cited by 296 · see citing works
Farre, A., & Rapley, T. (2017) · Healthcare · doi:10.3390/healthcare5040088 · Cited by 276 · see citing works
Martin-Misener, R., Harbman, P., Donald, F., Reid, K., Kilpatrick, K., Carter, N., Bryant-Lukosius, D., Kaasalainen, S., Marshall, D. A., Charbonneau-Smith, R., et al. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-007167 · Cited by 252 · see citing works
Pace-Schott, E. F., Amole, M. C., Aue, T., Balconi, M., Bylsma, L. M., Critchley, H., Demaree, H. A., Friedman, B. H., Gooding, A. E. K., Gosseries, O., et al. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.05.002 · Cited by 221 · see citing works
“, 1998), a method associated with high patient satisfaction and improved health outcomes (Smith et al., 2009; Smith et al., 2006).”
Self-citationWhat are the effective elements in patient-centered and multimorbidity care? A scoping review
Poitras, M.-E., Maltais, M.-E., Bestard-Denommé, L., Stewart, M., & Fortin, M. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3213-8 · Cited by 219 · see citing works
Kleinstäuber, M., Witthöft, M., & Hiller, W. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.09.001 · Cited by 212 · see citing works
An evidence-based patient-centered method makes the biopsychosocial model scientific
Smith, R. C., Fortin, A. H., Dwamena, F. C., & Frankel, R. M. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2012.12.010 · Cited by 155 · see citing works
Self-citationInterventions for War-Related Posttraumatic Stress Disorder
Hoge, C. W. (2011) · JAMA · doi:10.1001/jama.2011.1096 · Cited by 153 · see citing works
Sumathipala, A. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31815b5cf6 · Cited by 151 · see citing works
Engel, C. C., Oxman, T. E., Yamamoto, C., Gould, D., Barry, S., Stewart, P., Kroenke, K., Williams, J. W., & Dietrich, A. J. (2008) · Military Medicine · doi:10.7205/milmed.173.10.935 · Cited by 153 · see citing works
Liu, J., Gill, N. S., Teodorczuk, A., Li, Z., & Sun, J. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.10.114 · Cited by 148 · see citing works
Hinchey, S., & Jackson, J. L. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1620-6 · Cited by 140 · see citing works
Collaborative Chronic Care Models for Mental Health Conditions
Miller, C. J., Grogan‐Kaylor, A. C., Perron, B. E., Kilbourne, A. M., Woltmann, E. M., & Bauer, M. S. (2013) · Medical Care · doi:10.1097/mlr.0b013e3182a3e4c4 · Cited by 130 · see citing works
Classification and Diagnosis of Patients with Medically Unexplained Symptoms
Smith, R. C., & Dwamena, F. C. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-006-0067-2 · Cited by 129 · see citing works
Self-citationHenry, S. G., Holmboe, E. S., & Frankel, R. M. (2013) · Medical Teacher · doi:10.3109/0142159x.2013.769677 · Cited by 127 · see citing works
Kroenke, K., & Rosmalen, J. G. M. (2006) · Medical Clinics of North America · doi:10.1016/j.mcna.2006.04.003 · Cited by 115 · see citing works
Escobar, J. I., Gara, M. A., Diaz-Martinez, A. M., Interian, A., Warman, M., Allen, L. A., Woolfolk, R. L., Jahn, E., & Rodgers, D. (2007) · The Annals of Family Medicine · doi:10.1370/afm.702 · Cited by 113 · see citing works
Morriss, R., Dowrick, C., Salmon, P., Peters, S., Dunn, G., Rogers, A., Lewis, B., Charles-Jones, H., Hogg, J., Clifford, R., et al. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.040683 · Cited by 112 · see citing works
Association of costs with somatic symptom severity in patients with medically unexplained symptoms
Konnopka, A., Kaufmann, C., König, H.-H., Heider, D., Wild, B., Szecsenyi, J., Herzog, W., Heinrich, S., & Schaefert, R. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.08.011 · Cited by 109 · see citing works
Roenneberg, C., Sattel, H., Schaefert, R., Henningsen, P., & Hausteiner-Wiehle, C. (2019) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2019.0553 · Cited by 111 · see citing works
Somatization Increases Disability Independent of Comorbidity
Harris, A. M., Orav, E. J., Bates, D. W., & BARSKY, A. J. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0845-0 · Cited by 109 · see citing works
Edwards, T. M., Stern, A., Clarke, D. D., Ivbijaro, G. O., & Kasney, L. M. (2010) · PubMed Central · Cited by 104 · see citing works
Fink, P., & Rosendal, M. (2008) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e3282f51254 · Cited by 105 · see citing works
Castelnuovo, G., Giusti, E. M., Manzoni, G. M., Saviola, D., Gatti, A., Gabrielli, S., Lacerenza, M., Pietrabissa, G., Cattivelli, R., Spatola, C. A. M., et al. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00115 · Cited by 91 · see citing works
Medically unexplained symptoms and the disease label
Jutel, A. (2010) · Social Theory & Health · doi:10.1057/sth.2009.21 · Cited by 90 · see citing works
Saunders, N. R., Gandhi, S., Chen, S. D. M., Vigod, S. N., Fung, K., Souza, C. M. D., Saab, H., & Kurdyak, P. A. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.11295 · Cited by 83 · see citing works
Depression Screening and Measurement-Based Care in Primary Care
Siniscalchi, K. A. S., Broome, M. E., Fish, J., Ventimiglia, J., Thompson, J. A., Roy, P., Pipes, R., & Trivedi, M. H. (2020) · Journal of Primary Care & Community Health · doi:10.1177/2150132720931261 · Cited by 79 · see citing works
Behaviorally Defined Patient-Centered Communication—A Narrative Review of the Literature
Smith, R. C., Dwamena, F. C., Grover, M., Coffey, J. B., & Frankel, R. M. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1496-5 · Cited by 78 · see citing works
Self-citationMedically unexplained symptoms in primary care
Guthrie, E. (2008) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.106.003335 · Cited by 77 · see citing works
Enhanced care by generalists for functional somatic symptoms and disorders in primary care
Rosendal, M., Blankenstein, A. H., Morriss, R. K., Fink, P., Sharpe, M., & Burton, C. D. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008142.pub2 · Cited by 77 · see citing works
Cognitive behavioral therapy for somatoform disorders
Allen, L. A., & Woolfolk, R. L. (2010) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2010.04.014 · Cited by 70 · see citing works
Schaefert, R., Kaufmann, C., Wild, B., Schellberg, D., Boelter, R., Faber, R., Szécsényi, J., Sauer, N., Guthrie, E., & Herzog, W. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000343652 · Cited by 69 · see citing works
Medically unexplained symptoms as a threat to patients’ identity?
Burbaum, C., Stresing, A.-M., Fritzsche, K., Auer, P. L., Wirsching, M., & Lucius-Hoene, G. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2009.09.043 · Cited by 70 · see citing works
Shannon, R. A., Bergren, M. D., & Matthews, A. K. (2010) · The Journal of School Nursing · doi:10.1177/1059840509356777 · Cited by 67 · see citing works
Leaviss, J., Davis, S., Ren, S., Hamilton, J., Scope, A., Booth, A., Sutton, A., Parry, G. D., Buszewicz, M., Moss-Morris, R. E., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24460 · Cited by 67 · see citing works
Donald, F., Kilpatrick, K., Reid, K., Carter, N., Martin-Misener, R., Bryant-Lukosius, D., Harbman, P., Kaasalainen, S., Marshall, D. A., Charbonneau-Smith, R., et al. (2014) · Nursing Research and Practice · doi:10.1155/2014/896587 · Cited by 59 · see citing works
Dwamena, F. C., Lyles, J. S., Frankel, R. M., & Smith, R. C. (2009) · BMC Family Practice · doi:10.1186/1471-2296-10-67 · Cited by 58 · see citing works
Self-citationBurton, C. D., Weller, D., Marsden, W., Worth, A., & Sharpe, M. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000513 · Cited by 52 · see citing works
Burton, C. D., McGorm, K. J., Richardson, G. A., Weller, D., & Sharpe, M. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2011.12.009 · Cited by 53 · see citing works
Morriss, R. K., Kai, J., Atha, C., Avery, A. J., Bayes, S. J., Franklin, M. K., George, T., James, M., Malins, S., McDonald, R., et al. (2012) · BMC Family Practice · doi:10.1186/1471-2296-13-39 · Cited by 50 · see citing works
Addressing mental health issues in primary care: an initial curriculum for medical residents
Smith, R. C., Laird-Fick, H., D’Mello, D., Dwamena, F. C., Romain, A., Olson, J., Kent, K., Blackman, K., Solomon, D., Spoolstra, M., et al. (2014) · Patient Education and Counseling · doi:10.1016/j.pec.2013.09.010 · Cited by 50 · see citing works
Self-citationRugg, S., Paterson, C., Britten, N., Bridges, J., & Griffiths, P. (2011) · British Journal of General Practice · doi:10.3399/bjgp11x577972 · Cited by 50 · see citing works
The association between somatization and disability in primary care patients
van der Leeuw, G., Gerrits, M. M. J. G., Terluin, B., Numans, M. E., Feltz-Cornelis, C. M. V. D., van der Horst, H. E., Penninx, B. W. J. H., & van Marwijk, H. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.03.001 · Cited by 46 · see citing works
Stone, L. (2014) · BMC Family Practice · doi:10.1186/s12875-014-0192-7 · Cited by 46 · see citing works
Fajarini, M., Setiawan, A., Sung, C., Chen, R., Liu, D., Lee, C., Niu, S., & Chou, K. (2024) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2024.104953 · Cited by 47 · see citing works
Arnold, I. A., de Waal, M. W. M., Eekhof, J. A., Assendelft, W. J., Spinhoven, P., & van Hemert, A. M. (2009) · Psychosomatics · doi:10.1016/s0033-3182(09)70845-x · Cited by 44 · see citing works
Luo, Z., Goddeeris, J. H., Gardiner, J. C., & Smith, R. C. (2007) · Psychiatric Services · doi:10.1176/appi.ps.58.8.1079 · Cited by 44 · see citing works
Self-citationPaterson, C., Taylor, R. S., Griffiths, P., Britten, N., Rugg, S., Bridges, J., McCallum, B., & Kite, G. (2011) · British Journal of General Practice · doi:10.3399/bjgp11x572689 · Cited by 44 · see citing works
What do patients with medically unexplained physical symptoms (MUPS) think? A qualitative study.
Nunes, J., Ventura, T., Encarnação, R., Pinto, P. R., & Santos, I. R. (2013) · PubMed Central · Cited by 43 · see citing works
Primary care physicians treat somatization
Smith, R. C., Gardiner, J. C., Luo, Z., Schooley, S., Lamerato, L., & Rost, K. (2009) · Journal of General Internal Medicine · doi:10.1007/s11606-009-0992-y · Cited by 41 · see citing works
Self-citationCreed, F. H., Kroenke, K., Henningsen, P., Gudi, A., & White, P. D. (2011) · Cambridge University Press eBooks · doi:10.1017/cbo9780511977862.004 · Cited by 40 · see citing works
Using patient‐centered interviewing skills to manage complex patient encounters in primary care
Lein, C., & Wills, C. E. (2007) · Journal of the American Academy of Nurse Practitioners · doi:10.1111/j.1745-7599.2007.00217.x · Cited by 40 · see citing works
Self-citationEngel, C. C., Bray, R. M., Jaycox, L. H., Freed, M. C., Zatzick, D., Lane, M. E., Brambilla, D. J., Olmsted, K. R., Vandermaas-Peeler, R., Litz, B. T., et al. (2014) · Contemporary Clinical Trials · doi:10.1016/j.cct.2014.10.002 · Cited by 39 · see citing works
Menon, V., Rajan, T. M., Kuppili, P. P., & Sarkar, S. (2017) · Indian Journal of Psychological Medicine · doi:10.4103/ijpsym.ijpsym_17_17 · Cited by 40 · see citing works
Howman, M., Walters, K. R., Rosenthal, J., Ajjawi, R., & Buszewicz, M. (2016) · BMC Medical Education · doi:10.1186/s12909-015-0523-y · Cited by 41 · see citing works
Medically Unexplained Symptoms
Isaac, M., & Paauw, D. S. (2014) · Medical Clinics of North America · doi:10.1016/j.mcna.2014.01.013 · Cited by 35 · see citing works
Löwe, B., Piontek, K., Daubmann, A., Härter, M. C., Wegscheider, K., König, H., & Mora, M. C. S. (2017) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000491 · Cited by 34 · see citing works
Collaborative stepped care for somatoform disorders: A pre–post-intervention study in primary care
Mora, M. C. S., Groß, B., Lau, K., Gumz, A., Wegscheider, K., & Löwe, B. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.11.004 · Cited by 33 · see citing works
Medically unexplained physical symptoms
Price, J. R. (2008) · Medicine · doi:10.1016/j.mpmed.2008.06.006 · Cited by 32 · see citing works
Making the biopsychosocial model more scientific—its general and specific models
Smith, R. C. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113568 · Cited by 31 · see citing works
Self-citationHaroun, D., Smits, F., van Etten-Jamaludin, F., Schene, A., van Weert, H., & ter Riet, G. (2016) · European Journal of General Practice · doi:10.3109/13814788.2016.1161751 · Cited by 31 · see citing works
“[25] Smith et al., using multi-step patient-centred methods, reported modest improvement of QoL and morbidity in FAs with MUS.[23]”
InfluentialKlett, C., & Anderer, F. A. (1989) · PubMed · Cited by 29 · see citing works
Dowrick, C., Chew-Graham, C., Lovell, K., Lamb, J., Aseem, S., Beatty, S., Bower, P., Burroughs, H., Clarke, P., Edwards, S., et al. (2013) · Programme Grants for Applied Research · doi:10.3310/pgfar01020 · Cited by 27 · see citing works
Lidén, E., Brämberg, E. B., & Svensson, S. A. (2015) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.3402/qhw.v10.27191 · Cited by 28 · see citing works
Uomoto, J. M., & Williams, R. M. (2009) · Rehabilitation Psychology · doi:10.1037/a0016907 · Cited by 27 · see citing works
Teaching the Medical Interview: Methods and Key Learning Issues in a Faculty Development Course
Hatem, D., Barrett, S., Hewson, M. G., Steele, D., Purwono, U., & Smith, R. C. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0408-9 · Cited by 27 · see citing works
Self-citationSarinopoulos, I. C., Hesson, A., Gordon, C., Lee, S. A., Wang, L., Dwamena, F. C., & Smith, R. C. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.10.021 · Cited by 25 · see citing works
Self-citationA Randomized Trial of Treatments for High-Utilizing Somatizing Patients
BARSKY, A. J., Ahern, D. K., Bauer, M. R., Nolido, N. V., & Orav, E. J. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-013-2392-6 · Cited by 28 · see citing works
Characterization of Fatigue States in Medicine and Psychiatry by Structured Interview
Bennett, B. K., Goldstein, D., Chen, M. Z., Davenport, T. A., Vollmer-Conna, U. S., Scott, E. M., Hickie, I. B., & Lloyd, A. R. (2014) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000061 · Cited by 25 · see citing works
Predictors of Premature Antidepressant Discontinuation in Functional Gastrointestinal Disorders
Sayuk, G. S., Elwing, J. E., Lustman, P. J., & Clouse, R. E. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318031391d · Cited by 24 · see citing works
Malins, S., Kai, J., Atha, C., Avery, A., Guo, B., James, M., Patel, S., Sampson, C., Stubley, M., & Morriss, R. (2016) · British Journal of General Practice · doi:10.3399/bjgp16x686569 · Cited by 23 · see citing works
A questionnaire identifying four key components of patient satisfaction with physician communication
Grayson-Sneed, K. A., Dwamena, F. C., Smith, S. W., Laird-Fick, H. S., Freilich, L., & Smith, R. C. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.01.002 · Cited by 23 · see citing works
Self-citationBrodeur, M., Margo-Dermer, E., Chouinard, M., & Hudon, C. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033351 · Cited by 23 · see citing works
Medically Unexplained Physical Symptoms in Children: Exploring Hospital Staff Perceptions
Furness, P. J., Glazebrook, C., Tay, J., Abbas, K., & Slaveska-Hollis, K. (2009) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104509338437 · Cited by 23 · see citing works
Behavioural and psychological management of somatic symptom disorders: An overview
Sharma, M. P., & Manjula, M. (2013) · International Review of Psychiatry · doi:10.3109/09540261.2012.746649 · Cited by 23 · see citing works
Concordance of illness perceptions: The key to improving care of medically unexplained symptoms
McAndrew, L. M., Friedlander, M. L., Phillips, L. A., Santos, S. L., & Helmer, D. A. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.05.015 · Cited by 23 · see citing works
Chronic Pain Syndromes and Their Laryngeal Manifestations
Piersiala, K., Akst, L. M., Hillel, A. T., & Best, S. R. (2020) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2020.0530 · Cited by 20 · see citing works
Mid-Level Providers in Gastroenterology
Dorn, S. D. (2010) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.275 · Cited by 20 · see citing works
Community physicians' strategies for patients with medically unexplained symptoms.
Anderson, M., Hartz, A. J., Nordin, T., Rosenbaum, M., Noyes, R., James, P. A., Ely, J., Agarwal, N., & Anderson, S. (2008) · PubMed · Cited by 19 · see citing works
Costly patients with unexplained medical symptoms: A high-risk population
Margalit, A., & El-Ad, A. (2008) · Patient Education and Counseling · doi:10.1016/j.pec.2007.09.020 · Cited by 19 · see citing works
Medically Unexplained Physical Symptoms
Jackson, J. L., George, S., & Hinchey, S. (2009) · Journal of General Internal Medicine · doi:10.1007/s11606-009-0932-x · Cited by 19 · see citing works
Scope, A., Leaviss, J., Booth, A., Sutton, A., Parry, G., Buszewicz, M., & Moss‐Morris, R. (2021) · British Journal of Health Psychology · doi:10.1111/bjhp.12521 · Cited by 18 · see citing works
Fryer, K., Sanders, T., Greco, M., Mooney, C., Deary, V., & Burton, C. (2023) · Patient Education and Counseling · doi:10.1016/j.pec.2023.107870 · Cited by 17 · see citing works
Wright, J., & O’Connor, K. (2014) · Medical Clinics of North America · doi:10.1016/j.mcna.2014.01.010 · Cited by 17 · see citing works
Gerger, H., Hlavica, M., Gaab, J., Münder, T., & Barth, J. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000380914 · Cited by 17 · see citing works
Training residents and nurses to work as a patient-centered care team on a medical ward
Laird-Fick, H. S., Solomon, D., Jodoin, C., Dwamena, F. C., Alexander, K., Rawsthorne, L., Banker, T., Gourineni, N., Aloka, F., Frankel, R. M., et al. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.05.018 · Cited by 17 · see citing works
Self-citationA linguistic study of patient-centered interviewing: Emergent interactional effects
Hesson, A., Sarinopoulos, I. C., Frankel, R. M., & Smith, R. C. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.06.005 · Cited by 16 · see citing works
Self-citationEstimating the prevalence of medically unexplained symptoms from primary care records
Morriss, R. K., Lindson, N., Coupland, C. A. C., Dex, G., & Avery, A. J. (2012) · Public Health · doi:10.1016/j.puhe.2012.05.008 · Cited by 14 · see citing works
Launer, J. (2009) · Postgraduate Medical Journal · doi:10.1136/pgmj.2009.087411 · Cited by 13 · see citing works
Smyth, P. S., Watson, K. E., & Tsuyuki, R. T. (2021) · Trials · doi:10.1186/s13063-021-05726-3 · Cited by 13 · see citing works
A research coding method for the basic patient-centered interview
Grayson-Sneed, K. A., Smith, S. W., & Smith, R. C. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.10.003 · Cited by 13 · see citing works
Self-citationRasmussen, N. H., Agerter, D. C., Colligan, R. C., Baird, M. A., Yunghans, C. E., & Cha, S. S. (2008) · PubMed Central · Cited by 12 · see citing works
Medically Unexplained Symptoms
Lipsitt, D. R., Joseph, R., Meyer, D. J., & Notman, M. T. (2015) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000055 · Cited by 13 · see citing works
Psychotherapeutische Ansätze für Patienten mit somatoformen Störungen
Gottschalk, J.-M., & Rief, W. (2012) · Der Nervenarzt · doi:10.1007/s00115-011-3445-x · Cited by 13 · see citing works
Shikino, K., Mito, T., Ohira, Y., Yokokawa, D., Katsuyama, Y., Ota, T., Sato, E., Hirose, Y., Yamashita, S., Suzuki, S., et al. (2022) · Internal Medicine · doi:10.2169/internalmedicine.0085-22 · Cited by 12 · see citing works
Patel, M., James, K., Moss-Morris, R. E., Husain, M., Ashworth, M. J., Frank, P., Ferreira, N., Mosweu, I., McCrone, P., Hotopf, M. H., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025513 · Cited by 12 · see citing works
- Authors
- Smith, R. C., Lyles, J. S., Gardiner, J. C., Sirbu, C., Hodges, A., Collins, C., Dwamena, F. C., Lein, C., Given, C. W., Given, B., & Goddeeris, J.
- Affiliations
- Michigan State University (US)
- Corresponding author
- Smith, Robert C.
- Venue
- Journal of General Internal Medicine
- Published
- 2006-07
- Volume
- 21
- Issue
- 7
- Pages
- 671-677
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC1924714
- OpenAlex
- W1986905167
- Cited by
- 187
- References
- 34
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 15 · 2020: 12 · 2019: 7 · 2018: 5 · 2017: 8 · 2016: 10 · 2015: 9 · 2014: 10 · 2013: 16 · 2012: 20
- FWCI
- 7.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh057099-03)
- National Institute of Mental Health (MH 57099)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Keywords
- medically unexplained symptoms, primary care, multidimensional intervention, cognitive behavioral therapy, mental health, quality of life, SF-36, bodily pain, predictors of treatment response, provider-patient relationship
- MeSH terms
- Adult, Aged, Mental Disorders, Education, Medical, Continuing, Female, Health Maintenance Organizations, Humans, Male, Mental Health, Middle Aged, Pain, Physicians, Family, Treatment Outcome, Patient Selection
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
