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BMC Primary Care
Published in: BMC Primary Care 1/2006

Open Access 01-12-2006 | Research article

Somatisation: illness perspectives of asylum seeker and refugee patients from the former country of Yugoslavia

Authors: Noelle Junod Perron, Patricia Hudelson

Published in: BMC Primary Care | Issue 1/2006

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Abstract

Background

Somatisation is particularly challenging in multicultural contexts where patients and physicians often differ in terms of their illness-related beliefs and practices and health care expectations. This paper reports on a exploratory study aimed at better understanding how asylum seeker and refugee patients from the former country of Yugoslavia who were identified by their physicians as somatising make sense of their suffering.

Methods

We conducted semi-structured interviews with 26 asylum seeker and refugee patients from the former country of Yugoslavia who attended the general medicine outpatient clinic of a Swiss teaching Hospital and were identified as presenting with somatisation. Interviews explored patients' illness perspectives and health care expectations. Interviews were audio taped, transcribed verbatim and analyzed to identify key themes in patients' narratives.

Results

Patients attributed the onset of symptoms to past traumatic experiences and tended to attribute their persistence to current living conditions and uncertain legal status. Patients formulated their suffering in both medical and social/legal terms, and sought help from physicians for both types of problems.

Conclusion

Awareness of how asylum seeker and refugee patients make sense of their suffering can help physicians to better understand patients' expectations of the clinical encounter, and the particular nature and constraints of the patient-provider relationship in the context of asylum.
Literature
1.
Escobar JI, Gara M, Silver RC, Waitzkin H, Holman A, Compton W: Somatisation disorder in primary care. Br J Psychiatry. 1998, 173: 262-6.CrossRefPubMed
2.
Kroenke K, Price RK: Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med. 1993, 153: 2474-80. 10.1001/archinte.153.21.2474.CrossRefPubMed
3.
Goldberg DP, Bridges K: Somatic presentations of psychiatric illness in primary care setting. J Psychosom Res. 1988, 32: 137-44. 10.1016/0022-3999(88)90048-7.CrossRefPubMed
4.
Mayou R, Bass C, Sharpe M: Treatment of functional somatic symptoms. 1995, Oxford: Oxford University Press
5.
Lipowski ZJ: Somatization: the concept and its clinical application. Am J Psychiatry. 1988, 145: 1358-68.CrossRefPubMed
6.
Rosen G, Kleinman A, Katon W: Somatization in family practice: a biopsychosocial approach. J Fam Pract. 1982, 14: 493-502.PubMed
7.
Hartz AJ, Noyes R, Bentler SE, Damiano PC, Willard JC, Momany ET: Unexplained symptoms in primary care: perspectives of doctors and patients. Gen Hosp Psychiatry. 2000, 22: 144-52. 10.1016/S0163-8343(00)00060-8.CrossRefPubMed
8.
Glenton C: Chronic back pain sufferers – striving for the sick role. Soc Sci Med. 2003, 57: 2243-52. 10.1016/S0277-9536(03)00130-8.CrossRefPubMed
9.
Cheung P: Somatisation as a presentation in depression and post-traumatic stress disorder among Cambodian refugees. Aust N Z J Psychiatry. 1993, 27: 422-8.CrossRefPubMed
10.
Hsu SI: Somatisation among Asian refugees and immigrants as a culturally-shaped illness behaviour. Ann Acad Med Singapore. 1999, 28: 841-5.PubMed
11.
Junod Perron N, Hudelson P: How do junior doctors working in a multicultural context make sense of somatisation?. Swiss Med Wkly. 2005, 135: 475-479.PubMed
12.
Hudelson P: Contextualizing cultural competence training of residents: results of a formative research study in Geneva, Switzerland. Accepted for publication in Medical Teacher.
13.
14.
Miller WL, Crabtree BF: Doing qualitative research: the dance of interpretation. 1999, Thousand Oaks, CA: Sage publication
15.
Kuckartz U: Winmax software for qualitative data analysis. 1998, Thousand Oaks, CA: Scolari Sage Publications, Inc
16.
Peters S, Stanley I, Rose M, Salmon P: Patients with medically unexplained symptoms: sources of patients' authority and implications for demands on medical care. Soc Sci Med. 1998, 46: 559-65. 10.1016/S0277-9536(97)00200-1.CrossRefPubMed
17.
Johansson EE, Hamberg K, Westman G, Lindgren G: The meanings of pain: an exploration of women's descriptions of symptoms. Soc Sci Med. 1999, 48: 1791-802. 10.1016/S0277-9536(99)00080-5.CrossRefPubMed
18.
Kirmayer LJ, Young A: Culture and somatization: clinical, epidemiological, and ethnographic perspectives. Psychosom Med. 1998, 60: 420-30.CrossRefPubMed
19.
Baarnhielm S, Ekblad S: Turkish migrant women encountering health care in Stockholm: a qualitative study of somatization and illness meaning. Cult Med Psychiatry. 2000, 24: 431-52. 10.1023/A:1005671732703.CrossRefPubMed
20.
Markovic M, Manderson L, Kehaler M: The health of immigrant women: Queensland women from former Yugoslavia. J Immigrant Health. 2002, 4: 5-15. 10.1023/A:1013003126561.CrossRef
21.
Kilcher A, Spiess R: Die hausärtzliche Betreuung von Migranten/-innen mit chronischem Schmerzsyndrom. Schweizerische Ärtzezeitung. 2003, 84: 452-460.
22.
Ritsner M, Ponizovsky A, Kurs R, Modai I: Somatization in an immigrant population in Israel: a community survey of prevalence, risk factors, and help-seeking behavior. Am J Psychiatry. 2000, 157: 385-92. 10.1176/appi.ajp.157.3.385.CrossRefPubMed
23.
Lin EH, Carter WB, Kleinman AM: An exploration of somatization among Asian refugees and immigrants in primary care. Am J Public Health. 1985, 75: 1080-4.CrossRefPubMedPubMedCentral
24.
Westermeyer J, Bouafuely M, Neider J, Callies A: Somatization among refugees: an epidemiologic study. Psychosomatics. 1989, 30: 34-43.CrossRefPubMed
25.
Castillo R, Waitzkin H, Ramirez Y, Escobar JI: Somatization in primary care, with a focus on immigrants and refugees. Arch Fam Med. 1995, 4: 637-46. 10.1001/archfami.4.7.637.CrossRefPubMed
26.
Henley A, Schott J: Culture, religion and patient care in a multi-ethnic society: a handbook for professionals'. 1999, London: Age concern
27.
Sinnerbrink I, Silove D, Field A, Steel Z, Manicavasagar V: Compounding of premigration trauma and postmigration stress in asylum seekers. J Psychol. 1997, 131: 463-70.CrossRefPubMed
28.
Silove D, Steel Z, McGorry P, Mohan P: Trauma exposure, postmigration stressors, and symptoms of anxiety, depression and post-traumatic stress in Tamil asylum-seekers: comparison with refugees and immigrants. Acta Psychiatr Scand. 1998, 97: 175-81.CrossRefPubMed
29.
Simon GE, Von Korff M: Somatization and psychiatric disorder in the NIMH Epidemiologic Catchment Area study. Am J Psychiatry. 1991, 148: 1494-500.CrossRefPubMed
30.
Salis Gross C: Struggling with imaginaries of trauma and trust. The refugee experience in Switzerland. Cult Med Psychiatry. 2004, 28: 151-167. 10.1023/B:MEDI.0000034408.60968.eb.CrossRef
31.
Summerfield D: The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category. Bmj. 2001, 322: 95-98. 10.1136/bmj.322.7278.95.CrossRefPubMedPubMedCentral
32.
Young A: The harmony of illusion: inventing posttraumatic distress. 1995, Princeton NJ: Princeton University Press
33.
Hadler NM: If you have to prove you are ill, you can't get well. The object lesson of fibromyalgia. Spine. 1996, 21: 2397-400. 10.1097/00007632-199610150-00021.CrossRefPubMed
34.
Groleau D, Kirmayer LJ: Sociosomatic theory in vietnamese immigrants' narratives of distress. Anthropology & Medicine. 2004, 11: 117-133. 10.1080/13648470410001678631.CrossRef
35.
Kirmayer LJ: Broken narratives: clinical encounters and the poetics of illness experience. Narrative and the cultural construction of illness and healing. Edited by: Mattingly C, Garro L. 2000, Berkeley: University of California Press
36.
Kirmayer LJ: Mind and body as metaphors: hidden values in biomedicine. Biomedicine examined. Edited by: Lock M, Gordon D. 1988, Dordrecht: Kluwer Academic publishers
37.
Watters C: Emerging paradigms in the mental health care of refugees. Soc Sci Med. 2001, 52: 1709-18. 10.1016/S0277-9536(00)00284-7.CrossRefPubMed
Metadata
Title
Somatisation: illness perspectives of asylum seeker and refugee patients from the former country of Yugoslavia
Authors
Noelle Junod Perron
Patricia Hudelson
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2006
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-7-10

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