A 48-year-old woman comes to the doctor complaining of vague pains in the abdomen, legs, and thighs. Physical examination reveals no obvious signs of injury or trauma to account for the reported symptoms. If the woman told the doctor, “In spite of what you say, doctor, I know that I have a serious illness, probably cancer,” which of the following would be the most appropriate next step in treatment?
(A) ask why she thinks she has cancer
(B) tell her that she does not have cancer
© tell her that she has anxiety
(D) tell her that she has depression
(E) tell her to see a psychiatrist
(A) When a patient presents with a conviction that she has a serious illness, it is important to find out more about why the patient has the notion, because in the process the doctor may be able to diagnose emotional distress in the form of anxiety, depression, or simple misperception, as well as hypochondriasis. All the other choices (B, C, D, and E) bring about a premature closure.