The Bifocal Strategy

Abstract

SummaryA discrepancy exists between what is known about those conditions which are termed today in the DSM-IV somatizations or somatoform disorders and the fact that only 1-10% of the patients classified in these categories are seen by a psychiatrist or psychologist. Much is however at stake, considering the discomfort of these conditions, their complications (eg. acute attacks of bronchial asthma, myocardial infarction) and their high cost to society.The bifocal strategy, used experimentally for more than 16 years on a group of 180 patients, belongs to the ambit of liaison psychiatry. It is marked by a practical concern to defuse the process of somatization. This strategy has proved useful from several points of view, as it has enabled:• the design of a simple but efficient model for close collaboration between the somatic practitioner and the liaison psychiatrist;• the defusing, in an appreciable proportion of cases, of the somatization process;• a significant contribution to be made to health-care policy in Belgium, with official recognition and renewed status being accorded to liaison psychiatry.