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September 22, 1984BMJ144 citationsOpen Access

Symptoms and signs: physical disease or illness behaviour?

GWG WaddellMBM. BircherDFD. Finlayson

Key Points

  • To assess whether medical treatment received for backache is primarily determined by physical disease severity or by patient distress and illness behaviour.
  • Evaluated clinical data from 380 patients presenting with backache.
  • Analyzed associations between physical disease, psychological distress, illness behaviour, and the total amount of treatment received.
  • Treatment volume was influenced more strongly by patient distress and illness behaviour than by physical disease.
  • Patients demonstrating high levels of inappropriate illness behaviour received significantly more treatment (p < 0.001).

Abstract

The amount of treatment received by 380 patients with backache was found to have been influenced more by their distress and illness behaviour than by the actual physical disease. Patients showing a large amount of inappropriate illness behaviour had received significantly more treatment (p less than 0.001). The symptoms and signs of illness behaviour need to be clearly distinguished from those of physical disease, and better assessment of illness behaviour is essential if everyday clinical practice is to fulfil the ideal of treating patients as well as diseases.

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Cite This Study

Waddell et al. (1984) studied this question.

synapsesocial.com/papers/69dbdc739e6f14d6f16847ddhttps://doi.org/10.1136/bmj.289.6447.739
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