Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander hoofdstuk

2022 | OriginalPaper | Hoofdstuk

7. Aanhoudende lichamelijke klachten

Auteurs : dr. Tim olde Hartman, dr. Peter Lucassen

Gepubliceerd in: Gendersensitieve huisartsgeneeskunde

Uitgeverij: Bohn Stafleu van Loghum

share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Aanhoudende lichamelijke klachten (ALK) komen zeer veel voor; bij vrouwen meer dan bij mannen. Slechts een deel van degenen met klachten gaat naar een huisarts; ook hier zijn vrouwen in de meerderheid. Ernstige aanhoudende lichamelijke klachten komen in 2,5 % van de consulten bij de huisarts voor. Hormonale verschillen, aangeleerd gedrag en negatieve affectiviteit lijken relevante verklaringen voor de man-vrouwverschillen in vóórkomen van klachten en klachtpresentatie. De wijze van consultvoering is ook een factor die de klachten bij deze patiënten in stand houdt. Daarbij is nog onduidelijk in hoeverre verschillen in consultstijl tussen mannen en vrouwen een rol spelen. Door de armoede aan therapeutische behandelmogelijkheden en het gebrek aan acceptatie van psychologische behandelvormen door patiënten, is het duidelijk dat consultvoering een belangrijk middel is om tot bevredigende oplossingen te komen. Daarbij is essentieel het consult te voeren in een ‘feminiene’ stijl, gekenmerkt door ruimte voor de inbreng van de patiënt, een warme empathische sfeer, een goede gezamenlijke probleemomschrijving en het gezamenlijk kiezen van de weg voor verbetering.
Literatuur
1.
go back to reference Ballering A, Bonvanie IJ, olde Hartman TC, Monden R, Rosmalen JGM. Gender and sex independently associate with common somatic symptoms and lifetime prevalence of chronic disease. Soc Sci Med. 2020;253:112968. Ballering A, Bonvanie IJ, olde Hartman TC, Monden R, Rosmalen JGM. Gender and sex independently associate with common somatic symptoms and lifetime prevalence of chronic disease. Soc Sci Med. 2020;253:112968.
2.
go back to reference Bingefors K, Isacson D. Epidemiology, comorbidity and impact on health related quality of life of self-reported headache and musculoskeletal pain – a gender perspective. Eur J Pain. 2004;8:435–50. CrossRef Bingefors K, Isacson D. Epidemiology, comorbidity and impact on health related quality of life of self-reported headache and musculoskeletal pain – a gender perspective. Eur J Pain. 2004;8:435–50. CrossRef
3.
go back to reference Koopmans GT, Lamers LM. Gender and health care utilization: the role of mental distress and help-seeking propensity. Soc Sci Med. 2007;64:1216–30. CrossRef Koopmans GT, Lamers LM. Gender and health care utilization: the role of mental distress and help-seeking propensity. Soc Sci Med. 2007;64:1216–30. CrossRef
4.
go back to reference Ballering AV, Muijres D, Uijen AA, Rosmalen JGM, olde Hartman TC. [Manuscript in preparation] Sex differences in the diagnostic trajectories and final diagnosis of patients presenting with common somatic symptoms in primary care. Ballering AV, Muijres D, Uijen AA, Rosmalen JGM, olde Hartman TC. [Manuscript in preparation] Sex differences in the diagnostic trajectories and final diagnosis of patients presenting with common somatic symptoms in primary care.
6.
go back to reference Monden R, Rosmalen JGM, Wardenaar KJ, Creed F. Predictors of new onsets of irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia: the lifelines study. Psychol Med. 2020;50:1–9. CrossRef Monden R, Rosmalen JGM, Wardenaar KJ, Creed F. Predictors of new onsets of irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia: the lifelines study. Psychol Med. 2020;50:1–9. CrossRef
7.
go back to reference Green LA, Fryer GE, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. New Engl J Med. 2001;344:2021–5. CrossRef Green LA, Fryer GE, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. New Engl J Med. 2001;344:2021–5. CrossRef
8.
go back to reference Groeneveld JM, Ballering AV, van Boven K, Akkermans RP, olde Hartman TC, Uijen A. Sex differences in incidence of respiratory symptoms and management by general practitioners. Fam Pract. 2020;37:631–6. Groeneveld JM, Ballering AV, van Boven K, Akkermans RP, olde Hartman TC, Uijen A. Sex differences in incidence of respiratory symptoms and management by general practitioners. Fam Pract. 2020;37:631–6.
9.
go back to reference Ladwig KH, Marten-Mittag B, Formanek B, Dammann G. Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol. 2000;16:511–8. CrossRef Ladwig KH, Marten-Mittag B, Formanek B, Dammann G. Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol. 2000;16:511–8. CrossRef
10.
go back to reference Kroenke K, Mangelsdorff D. Common symptoms in ambulatory care: incidence, evaluation, therapy and outcome. Am J Med. 1989;86:262–6. CrossRef Kroenke K, Mangelsdorff D. Common symptoms in ambulatory care: incidence, evaluation, therapy and outcome. Am J Med. 1989;86:262–6. CrossRef
11.
go back to reference Kisely S, Goldberg D, Simon G. A comparison between somatic symptoms with and without clear organic cause: results of an international study. Psychol Med. 1997;27(5):1011–9. CrossRef Kisely S, Goldberg D, Simon G. A comparison between somatic symptoms with and without clear organic cause: results of an international study. Psychol Med. 1997;27(5):1011–9. CrossRef
12.
go back to reference Tomenson B, Essau C, Jacobi F, Ladwig KH, Leiknes KA, Lieb R, et al. Total somatic symptom score as a predictor of health outcome in somatic symptom disorders. Br J Psychatry. 2013;203:373–80. CrossRef Tomenson B, Essau C, Jacobi F, Ladwig KH, Leiknes KA, Lieb R, et al. Total somatic symptom score as a predictor of health outcome in somatic symptom disorders. Br J Psychatry. 2013;203:373–80. CrossRef
13.
go back to reference Verhaak PFM, Meijer SA, Visser AP, Wolters G. Persistent presentation of medically unexplained symptoms in general practice. Fam Pract. 2006;23:414–20. CrossRef Verhaak PFM, Meijer SA, Visser AP, Wolters G. Persistent presentation of medically unexplained symptoms in general practice. Fam Pract. 2006;23:414–20. CrossRef
14.
go back to reference Van Boven K, Lucassen P, Van Ravesteijn H, olde Hartman T, Bor H, van Weel-Baumgarten E et al. Do unexplained symptoms predict anxiety or depression? Ten-year data from a practice-based research network. Br J Gen Pract. 2011;61:e316–25. Van Boven K, Lucassen P, Van Ravesteijn H, olde Hartman T, Bor H, van Weel-Baumgarten E et al. Do unexplained symptoms predict anxiety or depression? Ten-year data from a practice-based research network. Br J Gen Pract. 2011;61:e316–25.
15.
go back to reference De Waal MW, Arnold IA, Eekhof JA, Van Hemert AM. Somatoform disorders in general practice: prevalence, functional impairment and comorbidity with anxiety and depressive disorders. Br J Psychiatry. 2004;184:470–6. CrossRef De Waal MW, Arnold IA, Eekhof JA, Van Hemert AM. Somatoform disorders in general practice: prevalence, functional impairment and comorbidity with anxiety and depressive disorders. Br J Psychiatry. 2004;184:470–6. CrossRef
16.
go back to reference Nimnuan C, Hotopj M, Wessely S. Medically unexplained symptoms. An epidemiological study in seven specialties. J Psychosom Res. 2001;51:361–7. Nimnuan C, Hotopj M, Wessely S. Medically unexplained symptoms. An epidemiological study in seven specialties. J Psychosom Res. 2001;51:361–7.
17.
go back to reference Maiden NL, Hurst NP, Lochhead Am Carson AJ, Sharpe M. Medically unexplained symptoms in patients referred to a specialist rheumatology service: prevalence and associations. Rheumatology. 2003;43:108–12. Maiden NL, Hurst NP, Lochhead Am Carson AJ, Sharpe M. Medically unexplained symptoms in patients referred to a specialist rheumatology service: prevalence and associations. Rheumatology. 2003;43:108–12.
18.
go back to reference Van der Boom KJ, Houtveen JH. Psychiatrische comorbiditeit bij ernstige somatoforme stoornissen in de derde lijn. Tijdschr Psychiatrie. 2014;56:743–7. Van der Boom KJ, Houtveen JH. Psychiatrische comorbiditeit bij ernstige somatoforme stoornissen in de derde lijn. Tijdschr Psychiatrie. 2014;56:743–7.
19.
go back to reference Melchior M, Poisbeau P, Gaumond I, Marchand S. Insights into the mechanisms and the emergence of sex-differences in pain. Neuroscience. 2016;338:63–80. CrossRef Melchior M, Poisbeau P, Gaumond I, Marchand S. Insights into the mechanisms and the emergence of sex-differences in pain. Neuroscience. 2016;338:63–80. CrossRef
20.
go back to reference Vargas-Prada S, Coggon D, Ntani G, Walker-Bone K, Palmer KT, Felli VE et al. Descriptive epidemiology of somatising tendency: findings from the CUPID study. Plos One. 2016;11:e0153748. Vargas-Prada S, Coggon D, Ntani G, Walker-Bone K, Palmer KT, Felli VE et al. Descriptive epidemiology of somatising tendency: findings from the CUPID study. Plos One. 2016;11:e0153748.
21.
go back to reference Ormel J, Bastiaansen A Riese H, Bos EH, Servaas M, Ellenbogen M et al. The biological and psychological basis of neuroticism: current status and future directions. Neuroscience Biobehav Rev. 2013;37:59–72. Ormel J, Bastiaansen A Riese H, Bos EH, Servaas M, Ellenbogen M et al. The biological and psychological basis of neuroticism: current status and future directions. Neuroscience Biobehav Rev. 2013;37:59–72.
22.
go back to reference Salmon P. Conflict, collusion or collaboration in consultations about medically unexplained symptoms: the need for a curriculum of medical explanation. Pat Educ Couns. 2007;67:246–54. CrossRef Salmon P. Conflict, collusion or collaboration in consultations about medically unexplained symptoms: the need for a curriculum of medical explanation. Pat Educ Couns. 2007;67:246–54. CrossRef
23.
go back to reference Menz F, Al-Roubaie A. Interruptions, status and gender in medical interviews: The harder you brake, the longer it takes. Discourse Soc. 2008;19:645–66. CrossRef Menz F, Al-Roubaie A. Interruptions, status and gender in medical interviews: The harder you brake, the longer it takes. Discourse Soc. 2008;19:645–66. CrossRef
24.
go back to reference Clareus B, Renström EA. Physicians’ gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient-physician relations. Scand J Psychol. 2019;60:338–47. PubMedPubMedCentral Clareus B, Renström EA. Physicians’ gender bias in the diagnostic assessment of medically unexplained symptoms and its effect on patient-physician relations. Scand J Psychol. 2019;60:338–47. PubMedPubMedCentral
25.
go back to reference Gol J, Rosmalen JGM, Gans ROB, Oude Voshaar RC. The importance of contextual aspects of care for patients with functional somatic symptoms. Med Hypotheses. 2020;142:109731. 2020;37:631-636. Gol J, Rosmalen JGM, Gans ROB, Oude Voshaar RC. The importance of contextual aspects of care for patients with functional somatic symptoms. Med Hypotheses. 2020;142:109731. 2020;37:631-636.
26.
go back to reference Olde Hartman TC, Hassink-Franke LJ, Lucassen P, van Spaendock KP, van Weel C. Explanations and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study. BMC Fam Pract. 2009;10:68. Olde Hartman TC, Hassink-Franke LJ, Lucassen P, van Spaendock KP, van Weel C. Explanations and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study. BMC Fam Pract. 2009;10:68.
27.
go back to reference Terpstra T, Gol J, Lucassen P, Houwen J, Van Dulmen S, Berger MY, et al. Explanations for medically unexplained symptoms – a qualitative study. Fam Pract. 2020;37:124–30. PubMed Terpstra T, Gol J, Lucassen P, Houwen J, Van Dulmen S, Berger MY, et al. Explanations for medically unexplained symptoms – a qualitative study. Fam Pract. 2020;37:124–30. PubMed
28.
go back to reference Den Boer C, Terluin B, Van Wilgen P. Uitleg aan patiënten met onverklaarde klachten. Ned Tijdschr Geneeskd. 2020;164:40–5. Den Boer C, Terluin B, Van Wilgen P. Uitleg aan patiënten met onverklaarde klachten. Ned Tijdschr Geneeskd. 2020;164:40–5.
29.
go back to reference Van Gils A. Hanssen D, olde Hartman T, Rosmalen J. E-health bij SOLK: meerwaarde voor de huisartspraktijk? Huisarts Wet. 2020:12;37–42. Van Gils A. Hanssen D, olde Hartman T, Rosmalen J. E-health bij SOLK: meerwaarde voor de huisartspraktijk? Huisarts Wet. 2020:12;37–42.
30.
go back to reference Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet. 2007;369:946–55. CrossRef Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet. 2007;369:946–55. CrossRef
Metagegevens
Titel
Aanhoudende lichamelijke klachten
Auteurs
dr. Tim olde Hartman
dr. Peter Lucassen
Copyright
2022
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2707-2_7