Medical Professional

There is a successful new approach, called a Stress Check-Up, for patients with chronic functional syndromes (such as IBS, fibromyalgia, chronic pelvic pain etc) and medically unexplained symptoms (such as chronic pain, cough, globus, tinnitus, etc).  The term Stress Check-Up is used because it carries far less stigma than synonyms such as "Psychological Assessment" or "Mental Health Evaluation."

The Stress Check-Up is a diagnostic interview usually conducted by a mental health professional with special training.  Reassuringly for patients, it begins with obtaining the chronology of their physical illness and follows with assessment for current life stresses, prolonged effects of child abuse and subtle somatic presentations of Depression, PTSD and Anxiety. Treatment of these issues typically leads to significant improvement in physical symptoms.

Patients may be reluctant to consider this option, so a useful exam room sequence might include the following:

• Point out that stress is capable of causing real symptoms, at times even severe enough to justify hospitalization.
• Reassure your patients that you do not suspect mental illness or that the symptoms are in any way self-inflicted.  
• Note that the situation is complex enough that you would like the help of a specialist to uncover the causes.
• Explain that you wish to refer the patient for a Stress Check-Up.  (The Practitioner Directory in this web site will grow into a good resource.)  

You might also consider screening appropriate patients with the questionnaire available in the Publications section of this site.

The PPDA plans to work with you to improve outcomes in this challenging class of patients who often seem to have few good options. Over time we will add more information to this website to support you in giving appropriate patients confidence about seeing a mental health practitioner for a physical illness.