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Exploring cognitions in irritable bowel syndrome: implications for the role of the doctor.

Dulmen, A.M. van. Exploring cognitions in irritable bowel syndrome: implications for the role of the doctor. Nijmegen: Katholieke Universiteit Nijmegen, 1996.
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Doctors are frequently confronted with patients with abdominal complaints. In the majority of such cases, no somatic explanation can be found. These complaints are known as functional abdominal complaints or broadly defined irritable bowel syndrome (IBS). For these, often refractory complaints, there is no effective medica! treatment. Besides, the health-care-seeking behaviour of IBS-patients is not related to the severity of the complaints, but much more to psychological factors, such as complaint-related cognitions, emotions and behaviours, like attributing the complaints to somatic abnormalities and fear of cancer. These latter complaint dimensions do not only have relevance for IBS; patients with somatically explained abdominal complaints often report such cognitions and emotions as well. In addition, these non-somatic complaint dimensions are related to the course of the abdominal complaints. Complaints improve less the more patients worry about their complaint, the more they have catastrophizing thoughts about the complaints, and the more they attribute their complaints to somatic abnormalities.

The study described in this thesis addressed the role of these psychological factors in the contact between IBS-patients and their doctor at an out-patient clinic for internal medicine, and, furthermore, examined whether doctors can bring about behaviour modification and thereby complaint improvement in their patients.