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Psychother Psychosom. 1987;48(1-4):110-5.

Comprehensive management of persistent somatization: an innovative inpatient program.

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Clarke Institute of Psychiatry, Toronto, Ont., Canada.


Psychiatry has been largely unsuccessful in developing effective treatment strategies for patients with chronic somatization. They continue to utilize a disproportionate share of health care resources and experience personal distress and significant social and occupational dysfunction. The Psychosomatic Medicine Unit at the Clarke Institute of Psychiatry is attempting to treat these patients with a comprehensive treatment program that takes into account the multifactorial etiology of the disturbance. The unit is in a tertiary care facility and the patient population is heterogeneous with respect to the underlying psychiatric diagnosis and the duration of symptoms. All patients are significantly dysfunctional and have typically failed other treatment approaches. The treatment process begins with an assessment phase in which the patient is comprehensively evaluated from the physical and psychiatric perspectives. The rehabilitation phase consists of a variety of treatment modalities including group programs in goal-setting, life skills and interpersonal relations, group therapy, individual psychotherapy, family therapy, occupational therapy and vocational rehabilitation, biofeedback and physiotherapy. Psychotropic medications play an important role in some patients. This paper will describe the unit and its program in detail.

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