ABSTRACT

This chapter focuses on the psychosocial evaluation of the individual presenting with gastrointestinal symptoms. Many symptoms may lead to a diagnosis of an unambiguous gastrointestinal disorder. In any history-gathering interview, it is important for the physician to start with the patient’s chief complaint as the initial focus of inquiry before any psychosocial investigation takes place. After the physician has gathered descriptive information from the patient abut the symptom, it is useful to gather further specific data for both medical diagnosis and psychosocial assessment. Major Depression may also present with atypical features. Diagnostic criteria include mood reactivity (i.e., mood brightening in response to actual or potential positive events) accompanied by two or more of the following symptoms: significant weight gain or increased appetite, hypersomnia, leaden paralysis, or chronic interpersonal rejection sensitivity.