Discovering the Functional Illness in Interview

Toner M. Overley, MD
JAMA. 1963;186(8):776-777. doi:10.1001/jama.1963.63710080010008b.
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IT HAS LONG SEEMED DESIRABLE to be able to discover the functional illness without having recourse to numerous expensive, sometimes painful, laboratory examinations, all of which are normal. The research herein reported addresses itself to two problems: (1) What percentage of patients with a functional problem can be discovered by interview alone? and (2) What factors are most pertinent in leading to a functional diagnosis?

The University Diagnostic Clinic gets referrals from all over the state of patients who present some sort of diagnostic or management problem. It has long been felt that "functional" problems abounded in this clinic. Therefore, 50 patients were selected in a random fashion and interviewed for 1 hour by a psychiatrist. The interview was different from a usual medical interview only in that a complete review of systems was not elicited and the reaction of the patient and his family to his illness was


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