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The Amplification of Symptoms in the Medically Ill, 2022, Barsky and Silbersweig

Discussion in 'Other psychosomatic news and research' started by Andy, Jul 14, 2022.

  1. Andy

    Andy Committee Member

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    Hampshire, UK
    Abstract

    The mechanism of symptom amplification, developed in the study of somatization, may be helpful in caring for patients with symptoms that, while they have a demonstrable medical basis, are nonetheless disproportionately severe and distressing. Amplified medical symptoms are marked by disproportionate physical suffering, unduly negative thoughts and concerns about them, and elevated levels of health-related anxiety. They are accompanied by extensive and sustained illness behaviors, disproportionate difficulty compartmentalizing them and circumscribing their impact, and consequent problems and dissatisfaction with their medical care.

    A distinction has long been made between “medically explained” and “medically unexplained” symptoms. However, a more comprehensive view of symptom phenomenology undermines this distinction and places all symptoms along a smooth continuum regardless of cause: Recent findings in cognitive neuroscience suggest that all symptoms—regardless of origin—are processed through convergent pathways. The complete conscious experience of both medically “explained” and “unexplained” symptoms is an amalgam of a viscerosomatic sensation fused with its ascribed salience and the patient’s ideas, expectations, and concerns about the sensation. This emerging empirical evidence furnishes a basis for viewing persistent, disproportionately distressing symptoms of demonstrable disease along a continuum with medically unexplained symptoms.

    Thus, therapeutic modalities developed for somatization and medically unexplained symptoms can be helpful in the care of seriously ill medical patients with amplified symptoms. These interventions include educational groups for coping with chronic illness, cognitive therapies for dysfunctional thoughts, behavioral strategies for maladaptive illness behaviors, psychotherapy for associated emotional distress, and consultation with mental health professionals to assist the primary care physician with difficulties in medical management.

    Paywall, https://link.springer.com/article/10.1007/s11606-022-07699-8
     
    Last edited by a moderator: Jul 14, 2022
    Hutan and Peter Trewhitt like this.
  2. rvallee

    rvallee Senior Member (Voting Rights)

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    This is literally a current medical paradigm going back several decades, one that literally affirms that.

    Even though in all truth, this entire concept is still very much at the "may" phase. Despite decades of implementation, and millions of patients. And it's both. It both "may help" or "can be helpful", but also "is a complete cure", all at the same time. And no one cares about this blatant contradiction other than us.

    "May". You could have a dozen Theranos scandal in the time this nightmare has been going on, and who knows how many more?
     
    EzzieD, Amw66, Hutan and 5 others like this.
  3. Sean

    Sean Moderator Staff Member

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    MEMarge, chrisb and Hutan like this.
  4. Amw66

    Amw66 Senior Member (Voting Rights)

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    Timed to capture long COVID or am I becoming too cynical ?
     
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  5. Sean

    Sean Moderator Staff Member

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    cynical/realistic

    It's a fine line.
     
    Lilas and Amw66 like this.
  6. Hoopoe

    Hoopoe Senior Member (Voting Rights)

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    As far as I know, there's still no evidence somatization is actually a thing. They can't even define it clearly enough to allow falsification of the concept.

    Some people just really want to roleplay a thing where they explain to patients that their reality is false and that they're emotionally dysfunctional.
     
    EzzieD, SNT Gatchaman, Lilas and 8 others like this.
  7. chrisb

    chrisb Senior Member (Voting Rights)

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    Some say Good Old Harvard...

    others tell the truth.

    I wonder who was influencing their training in the 1980's
     
    CRG likes this.
  8. rvallee

    rvallee Senior Member (Voting Rights)

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    This was probably happening anyway. It's the general direction medicine has been taking for the last few decades. The main difference is that it will be higher profile, instead of being completely hidden. But I doubt it changed anything more than a few words. This ideology is completely indifferent to what happens in reality anyway.
     
    EzzieD, Sean and Amw66 like this.
  9. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    Lots of big words that say nothing. They've missed the forest for the trees, thinking that symptom presentation is the same as the experience of symptoms itself. They've failed to listen to patients that care about the impact of the symptoms on their lives, not the mere sensation.
     
    FMMM1, Mithriel, Lilas and 6 others like this.

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