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Patients with somatising disorders make disproportionate use of health
services and in the process may incur iatrogenic risk. On p 372 Salmon
et al report that most of these patients are dissatisfied with the
explanations doctors give for their symptoms. Patients perceive most
explanations as rejecting or colluding. A few patients were given
explanations that were satisfying and empowering. Empowering explanations usually explained possible mechanisms and involved patients in managing their own illness. Empowering explanations may be
able to influence patients with somatisation disorders, improving their
wellbeing and reducing the demands they make on health services.