[Improved prognosis of functional abdominal complaints by attending to psychic factors].

OBJECTIVE

To determine the assessment by physicians of psychic factors in patients with functional abdominal complaints, and the relationship between the assessment and the evolution of the abdominal complaints.

DESIGN

Prospective, descriptive.

SETTING

Outpatient Clinic Internal Medicine, University Hospital Nijmegen, the Netherlands.

METHODS

120 patients with functional abdominal complaints were asked to indicate by questionnaires the severity and meaning of their complaints prior to and at the end of the visits to their internist. Internists were asked how they rated the somatic and non-somatic complaint dimensions in their patients.

RESULTS

Overall, internists perceived the severity and details of the abdominal complaints correctly. Prognostically unfavourable complaint-related cognitions and emotions were perceived less correctly. During the outpatient consulting period, patients' anxiety and somatic attributions diminished, especially when the internist had perceived these aspects correctly. Six months after the first outpatient visit the abdominal complaints of these reassured patients had improved, compared with patients with persistent somatic attributions; the latter made more frequent use of health care services at follow-up (GP visits, drug use).

CONCLUSION

Systematic exploration of somatic and non-somatic complaint dimensions by physicians could be an important tool in improving the prognosis and diminishing the medical consumption in patients with functional abdominal complaints.