2010 Volume 50 Issue 3 Pages 201-208
The characteristics of the practice by primary care physicians in the community are accessibility, continuity, comprehensiveness, coordination, and accountability. So it is proper for them to see the elderly patients who have both somatic and psychosocial problems. My clinic is located at the urban area, and gives primary care services to the community people. Since May 1999 through Spring 2004, 4,476 patients visited my clinic. Among them, 322 patients (7.2%) were treated at the psychosomatic division. The number of patients over 65 years-old who visited that division was 64 (19.9%). Their three most frequent diagnoses were mood disorder, adjustment disorder, and anxiety disorder, which consisted 65.5% of these 64 patients. Three most frequent stressors which triggered the onset of the disorders were death of the partner, domestic conflicts and somatic impairments. Useful psychosomatic skills for primary care physicians, I think, are as follows. Medical interview skills which is based by Narrative based medicine, Biopsychosocial model, Family-oriented techniques, Cognitive therapy, Behavioral therapy and Psychotropic medication.
