[Psychiatric consultation at a general hospital (II): The problem of the patient with a somatic disorder].

The article presents the difficulties of the psychiatric consultation with patients having somatic complaints. A model of evaluation and intervention is proposed in which the link between the somatic complaint and the doctor-patient relationship is emphasized. A closer look at the manifest request for consultation often leads to interpreting the consultation as a symptom of the patient's relationship to his doctor. The consultation is often a confrontation with the hidden conflict of the patient embedded in his symptom, but actualized with his referring doctor. The focus is on the patient as the agent of his trouble. A clinical vignette is presented.