Abstract
In psychosomatic treatment, the improvement of clinical symptoms is related to therapeutic factors : intratherapeutic factors such as trust and reassurance towards a physician, expectation towards treatment including drugs and extratherapeutic factors. In this study we evaluated what such therapeutic factors contributed to the improvement of clinical symptoms with a short questionnaire, and how the outcomes are different depending on the experience of physicians. We surveyed all of the 336 psychosomatic outpatients who had been treated by three physicians in our hospital with a questionnaire after the consultation, all the patients were asked whether or not their symptoms improved and what factors were related to the improvement of their subjective symptoms. About 90% of patients reported on improvement in clinical symptoms inclusive of "slightly improved" and better response, which was not different in terms of physicians' experience. The major therapeutic factors regarding one physician with advanced experience were "trust and reassurance" (27%), "specific explanation" (20%), "suggestive words used by physician" (14%), "hope for recovery" (11%) and "drug" (9%). On the other hand, those regarding the other physicians with less experience were "trust and reassurance" (25%), "specific explanation" (18%). "drug" (14%), "hope for recovery" (11%) and "suggestive words used by physician" (11%). Also, the primary therapeutic factor regarding one physician with advanced experience included "trust and reassurance" (38%). "specific explanation" (23%), "events irrelevant to treatment" (11%), "suggestive words used by physician" (8%) and "drug" (8%). On the other hand, the primary therapeutic factor regarding the other physicians with less experience included "trust and reassurance" (27%), "drug" (20%), "specific explanation" (18%), "suggestive words used by physician" (8%) and "events irrelevant to treatment" (7%). In any case of physicians, "trust and reassurance" was the most important factor contributing to the improvement of patient's symptoms, and the second was "specific explanation". However, there was a different efficacy of "drug" among the physicians depending on experience. It was suggested that extratherapeutic factors, expectation and hope also influenced the improvement of symptoms.
