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Case Study, Chapter 21, Somatic Symptom Illnesses
1. This is Mr. Davis's third visit, this month, to the emergency room with the chief complaint of substernal chest pain. The cardiac workup performed at each visit concludes that his cardiac enzymes and troponin are negative and all ECG and chest x-rays are normal. Mr. Davis has been examined by a cardiologist, and his stress test is negative for ischemia. He has also been tested for gastrointestinal disease. The results of an EGD showed a mild gastritis. Despite these negative physical findings, Mr. Davis continues to express great concern regarding his cardiac health in spite of being repeatedly told by the various health-care professionals he has seen that his symptoms are not cardiac related. Mr. Davis states that he will seek a second opinion because he is convinced that all the doctors must be missing something. When his primary care physician suggests that he see a psychiatrist, Mr. Davis adamantly responds that he does not think he needs a psychiatric workup, and refuses the psychiatric referral. (Learning Objectives: 2 and 6)
a. Identify the three characteristic features of somatic symptom illnesses.
b. What are two interventions that would be appropriate for Mr. Davis?
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