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Advances in Psychiatric Treatment (2006) 12: 54-62
© 2006 The Royal College of Psychiatrists

Psychological approaches to somatisation in developing countries

Vikram Patel and Athula Sumathipala

Vikram Patel is a reader in international mental health at the London School of Hygiene and Tropical Medicine (NPHIRU, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. e-mail: Vikram.patel{at}lshtm.ac.uk). Athula Sumathipala is an honorary lecturer at the Institute of Psychiatry, London. Both authors are psychiatrists who have been working in South Asia, conducting research into public health aspects of mental disorders, particularly the efficacy and cost-effectiveness of locally available and feasible treatments in primary care, and building research capacity in the region. Both wish to acknowledge the Wellcome Trust for supporting their research on mental disorders in South Asia.

Medically unexplained somatic complaints are among the most common clinical presentations in primary care in developing countries and they are a considerable burden for patients and the healthcare system. They are assumed to be the result of psychosocial factors, and the process by which symptoms are experienced is termed somatisation. Common mental disorders, somatoform disorders and socioeconomic adversities are the major risk factors for these complaints. There is evidence suggesting that cognitive–behavioural therapy, which has proven efficacy for somatoform disorders in the developed world, can be used in developing countries with some adaptations (e.g. by simplifying the content so that it can be applied in primary care by non-specialist health practitioners; using culturally appropriate analogies; and delivering the intervention over fewer and shorter sessions). The main components of such an intervention are presented in this article.




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