BMJ  2006;333:136 (15 July), doi:10.1136/bmj.333.7559.136

Commentary

Power of the mind

¹ Maudsley Hospital, London SE5 8AZ Sabina.dosani@slam.nhs.uk

The first 150 words of the full text of this article appear below.

I hadn't heard of rumination syndrome before reading Mr Neville's story.¹ My first thought on hearing about his repeated presentation, negative findings, and distress was that this was a case of somatoform disorder.² His deterioration after a difficult meeting with a staff member supported that view.

Is rumination syndrome a distinct syndrome or is it an example of a functional somatic syndrome?³ It is unfortunate that mind-body dualism still dominates clinical discussions and management. To me, this sounds like a condition with psychogenic aetiology but physical manifestation. His symptoms are not "all in the mind," they are "all in the stomach"; understandably Mr Neville and his general practitioner sought advice from gastroenterologists.

Mr Neville started to feel better when he was given an explanation of his symptoms and learnt how to suppress contractions. Explanations that are tangible remove blame and involve patients in managing their illness and improve wellbeing. They . . . [Full text of this article]

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