Review of Medically unexplained illness: Gender and biopsychosocial implications.

Reviews the book, Medically unexplained illness: Gender and biopsychosocial implications by Susan K. Johnson (see record 2007-11978-000). Medically unexplained symptoms and illness present a clinical challenge in primary, secondary, and tertiary health care. The author surveys a broad spectrum of patient presentations ranging from subsyndromal medically unexplained symptoms to common functional disorders. The author's blending of gender into the discussion on etiologic factors, developmental course, and response to treatment addresses a long overdue foundational imperative for any survey of this literature. As with virtually all publications, the reviewer notes this book has limitations. First, the literature survey does not extend beyond 2006. Second, conspicuously absent is the coverage of alexithymia as a personality trait associated with somatization independent of somatic disease and confounding sociodemographic variables. Third, coverage of personality factors in general, and specifically the important construct of negative affectivity (NA) are limited to a sketchy review in the chapter on chronic fatigue syndrome. Fourth, stepped care models and the compelling clinical outcomes reported by Allen, Woolfolk, Escobar, Gara, and Hamer (2006) for cognitive-behavioral therapy and Smith et al. (2006) using a behavioral therapy approach is not addressed. Strengths of this book that set it apart from comparable publications that review and analyze the published literature, in the reviewer's opinion, are the emphasis on female gender. This volume will be useful to the clinician-scientist in either the primary or tertiary clinic setting interested in medically unexplained phenomena but particularly beneficial to the primary care provider who typically first encounters the patient with medically unexplained illness. (PsycINFO Database Record (c) 2011 APA, all rights reserved).