Posts Tagged ‘medical interview’

Patients Who Have “Nothing the Matter with Them”

Tuesday, June 9th, 2015

Among physicians with a humanistic soul, perhaps no quotation is more fondly remembered than one from Dr Francis Peabody.  He was born in 1881 to a prominent New England family, trained at Harvard and Massachusetts General Hospital and was the first director of the Thorndike Laboratory at Boston City Hospital.  Tragically, he died of sarcoma at age 46.


ACEs and Illness in Primary Care

Tuesday, February 10th, 2015

A colleague asked how I would screen for Adverse Childhood Experiences (ACEs) in primary care patients with unexplained illness, chronic pain or functional syndromes such as irritable bowel or fibromyalgia.  (A blog of mine describing ACEs is here with an important web site here). Here is my answer:


Psychosocial Context (2)

Monday, September 20th, 2010

Continuing from the last post,  recall that in my practice a large majority of over 7000 patients with medically unexplained symptoms were referred due to failure to grasp the their psychosocial issues.


Stress Illness Screening (3)

Tuesday, May 18th, 2010

The search continues for a valid, ultra-short screening questionnaire for stresses capable of causing physical illness.  Once that is in place, the next step is for primary care clinicians to learn how to further evaluate a patient with a positive screen.  This should then lead to systems for follow-up care and monitoring, including the option of referral to mental health clinicians experienced with patients who have physical symptoms.


Stress Illness Screening (2)

Wednesday, May 12th, 2010

In the last post we saw four questions (PHQ – 4) that screen for anxiety and depression.  These are described in the reference below (1).  However, to document that screening questions achieve their intended goals and are scientifically valid, it is not enough merely to come up with what sound like reasonable questions.


Stress Illness Screening (1)

Friday, May 7th, 2010

One of the most frequent questions I get after my talks to medical clinicians is about rapid ways to screen for sources of stress.  A validated questionnaire that revealed stress issues prior to the patient being seen would, theoretically, enable more accurate diagnosis in less time.


Blood Test for Stress Illness?

Wednesday, March 31st, 2010

Bethesda, Maryland.  April 1.  The Center for Irreproducible Results at the National Institution of Health today announced a stunning breakthrough that is certain to benefit hundreds of millions of patients.  Dr. Freddie P. Ignobel reports that she has found a blood test that can reliably confirm when physical symptoms are caused by life stresses and not by a disease of an organ or a metabolic problem.


Stress Illness Brochure (5)

Friday, December 18th, 2009

Concluding with Part 5 of the Stress Illness brochure:

IV. Stress From A Traumatic Experience


Stress Illness Brochure (4)

Thursday, December 17th, 2009

Continuing with Part 4 of the Stress Illness brochure:

III. A Disease Called Depression


Stress Illness Brochure (3)

Wednesday, December 16th, 2009

Continuing with Part 3 of the Stress Illness brochure:

II. Stress From The Child Within Us