Somatoform disorders

Somatoform disorders are a group of psychogenic diseases, in the clinical picture of which mental disorders hide behind somatic vegetative symptoms resembling somatic disease, but no organic manifestations can be identified that could be attributed to a disease known in medicine, although often there are nonspecific functional disorders.

Today, as a pathogenetic theory of the formation of somatoform disorders, it is customary to consider a neuropsychological concept based on the assumption that individuals with "somatic language" have a low threshold of tolerability of physical discomfort. What some people feel as tension, with somatoform disorders, is perceived as pain.

This evaluation becomes a conditioned reflex reinforcement of the emerging vicious circle, allegedly confirming the gloomy hypochondriacal premonitions of the patient. As a trigger mechanism, it is necessary to consider personally significant stressful situations. At the same time, there are more often not obvious ones, such as death or serious illness of relatives, troubles at work, divorce, etc., but minor troubles, chronic stressful situations at home and at work, to which people pay little attention how much seroquel does it take to overdose.

In the clinical picture of the disease, pathological bodily sensations predominate, presenting considerable difficulties for differential diagnosis. The manifestations of somatoform disorders are diverse, patients usually appeal primarily to therapists, then, not being satisfied with the lack of treatment results, to narrow specialists, use expensive, Sometimes invasive, diagnostic methods.

Somatic is framed by emotional instability, anxiety, reduced mood. Patients constantly complain about something, complaints are presented very dramatically. Despite the excessive detail, they are vague, inaccurate and inconsistent in time.

Patients are not likely to either reassure or convince themselves that the painful manifestations are associated with mental factors. The doctor has a natural, sometimes difficultly hidden irritation - and as a result, the patient continues to walk around the doctor in search of a "good doctor", the patient is often hospitalized in somatic hospitals and suffers from ineffective surgical interventions.

However, behind all these complaints are violations of the mental sphere, which can be identified by careful questioning: a low mood, not reaching the level of depression, the decline of physical and mental strength, in addition, there is often irritability, a sense of inner tension and dissatisfaction. The aggravation of the disease is provoked not by physical activity or changing weather conditions, but by emotionally significant stressful situations.

For the diagnosis to be made, it is first necessary to exclude somatic causes that can cause these complaints, and only then raise the question of the presence of somatoform disorder.

If the patient makes a lot of fuzzy complaints that do not find instrumental and laboratory confirmation, in the history of numerous examinations and consultations, the results of which he remains dissatisfied, it can be assumed that he suffers from somatoform disorder.

The number of somatoform disorders today includes:

At present, treatment of somatoform disorders includes a wide range of therapeutic and preventive measures, but the basic direction is the combination of psychotherapy and pharmacotherapy.

Patients are almost never able to accept the idea of ​​the psychic nature of excruciating somatic sensations. Therefore, the treatment program should be strictly individualized with the optimal combination of pharmacotherapy, psychotherapy, behavioral methods, social support and conducted primarily on an outpatient basis. Only with prolonged disease-free disease, resistance to standard therapeutic regimens is possible treatment in a specialized department.

Complications: There is a narrowing of the social space of life (refusal to communicate, active rest, career growth); Painful health concerns, the concentration of the whole mental life on the monitoring of their physical condition, irrational visits to doctors and the passage of laboratory examinations;

Development of secondary depression due to prolonged severe symptoms and loss of hope for recovery (secondary depression is noted in 60-70% of cases of somatoform disorder); Conflicts in the family, because sometimes its members, not understanding the causes of the state, tend to see the patients as hypochondriacs, overly fixed, egocentric, shirking their duties.

In addition to the main methods of therapy, physiotherapy and acupuncture are used.