Current medical assessment not sufficient; clinimetric methods may improve final outcomes

In a paper published in the current issue of Psychotherapy and Psychosomatics, Giovanni A. Fava (University of Bologna) and Nicoletta Sonino (University of Padova) summarize data which indicate that current medical assessment, by ignoring the psychosocial dimensions, is inadequate in most of medical encounters.

The primary goal of psychosomatic medicine is the incorporation of its operational strategies into clinical practice. The traditional attitude toward disease and the functional/organic dichotomy were criticized by George Engel in the early sixties. Only recently, however, there has been increasing awareness of the limitations of disease as the primary focus of medical care. It is not that certain disorders lack an organic explanation; it is our assessment that is inadequate in most clinical encounters. The research evidence which has accumulated in psychosomatic medicine offers unprecedented opportunities for the identification and treatment of medical problems.

Taking full advantage of clinimetric methods (such as the use of Emmelkamp's two levels of functional analysis and the Diagnostic Criteria for Psychosomatic Research) may greatly improve the clinical process, including shared decision making and self-management. Endorsement of the psychosomatic perspective may better clarify the pathophysiological links and mechanisms underlying symptom presentation. Pointing to individually targeted methods may improve final outcomes and quality of life.

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