This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Patient-Physician Relationship/ Care  • Patient-Physician Communication  • Primary Care/ Family Medicine  • Psychiatry  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: In response to Dr Trief, we noted that our study design does not permit us to determine how much of the treatment effect can be attributed specifically to the consultation letter. However, the multidimensional nature of the illness and the wide range of positive outcomes observed make it unlikely that the consultation letter had more than a very modest impact: not only did patients improve across a range of attitudinal, affective, cognitive, and behavioral domains, but their functional status and role impairment improved as well. It is difficult to attribute such widespread effects to a single letter. In addition, a substantial fraction of patients changed primary care physicians during the course of the follow-up interval, further diluting any effect the letter may have had. Finally, such a consultation letter has only been tested in somatization disorder, where its effect has not yet been conclusively established. Moreover, its effectiveness . . . [Full Text of this Article]

Arthur J. Barsky, MD
abarsky@partners.org

David K. Ahern, PhD
Department of Psychiatry
Brigham and Women's Hospital
Boston, Mass

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Interventions for Hypochondriasis in Primary Care
Paula M. Trief
JAMA. 2004;292(1):42.
EXTRACT | FULL TEXT  

Cognitive Behavior Therapy for Hypochondriasis: A Randomized Controlled Trial
Arthur J. Barsky and David K. Ahern
JAMA. 2004;291(12):1464-1470.
ABSTRACT | FULL TEXT