On humanising psychosomatic illness

Pseudo-fitters. Regular callers. Attention-seekers. A cry for help. To many who have worked in prehospital care, these terms will be familiar.

In the opening chapter of It's All in Your Head: Stories from the Frontline of Psychosomatic Illness, Dr. Suzanne O'Sullivan, a consultant neurologist and neurophysiologist postulates that on an average day, as many as a third of people who go to see their general practitioner have symptoms that are deemed medically unexplained (O'Sullivan, 2016).

Are these patients ‘faking’ their illnesses to gain attention, perhaps stealing valuable resources from those with genuine medical needs? Some surely will be. Malingering, or the simulation of illness for external gain, is prevalent in around 30% of patients being assessed in a litigation or disability-evaluation setting (Bass and Wade, 2019).

Dr. O'Sullivan suggests that the prevalence in general clinical practice, though, is far, far less—so much so that trying to ‘catch patients out’ is entirely unhelpful. The vast majority of patients with ‘medically unexplained symptoms’ are suffering illness entirely outside of their conscious control. So, are we doing these patients a disservice by casting them off as ‘fakers’? This engaging book provides some answers.