What Is Somatic Dysfunction?

Somatoform disorder is a neurosis characterized by persistent fear or belief in a dominant idea of various somatic symptoms. Patients repeatedly seek medical treatment for these symptoms. Negative medical tests and doctors' explanations cannot dispel their doubts. Even if there is sometimes a physical disorder, it does not explain the nature and extent of the symptoms reported, or the idea of pain and dominance. Often accompanied by anxiety or depression. Although the occurrence and persistence of symptoms are closely related to unpleasant life events, difficulties or conflicts, patients often deny the existence of psychological factors. They also refused to explore the possibility of psychological causes, even when they had significant depression and anxiety. It is difficult to understand the cause of the symptoms, both physically and psychologically. Patients often seek attention (performing) to a certain extent, and believe that the disease is somatic, and further examination is needed. If the patient cannot convince the doctor to accept this, he will be angry, and it is more likely to be accompanied by attention behavior. This disorder is common to both men and women and has a chronic fluctuating course.

Basic Information

English name

somatoformdisorders

Visiting department

Psychiatry

Common symptoms

Anxiety, depression

Contagious

no

Causes of somatoform disorders

The exact cause is unknown. Psychodynamic theory believes that patients with this disease are often clumsy to explore their own internal psychology, so they often insist on a physical cause. It is thought that the disorder is mainly caused by psychological factors.

Clinical manifestations of somatoform disorders

Somatization disorder

Somatization disorder mainly displays various and frequently changing physical symptoms. Symptoms can involve any system or organ of the body. The most important feature is the unpleasant mood caused by stress, which appears in a way that translates into physical symptoms.

The most common are gastrointestinal discomfort (such as pain, snoring, acid reflux, vomiting, nausea, etc.), abnormal skin sensations (such as itching, burning, tingling, numbness, soreness, etc.), skin spots, sexuality, and menstruation Complaints are also common, with significant depression and anxiety. There can be multiple symptoms. Patients have performed many tests for this, no positive findings, and even surgical exploration failed. It often has a chronic fluctuating disease course and is accompanied by long-standing serious obstacles in social, interpersonal, and family behavior, and rarely can be completely relieved. There are far more women than men, and they occur in early adulthood. The earliest symptoms of women may be related to sexual difficulties or marriage and love problems. Some patients may be drug dependent or abused due to frequent treatment (mostly sedatives and analgesics).

2. Undifferentiated somatoform disorder

If the course of disease is shorter than 2 years, and the clinical manifestations are consistent with somatization disorder or atypical, this type should be diagnosed.

3. Suspected condition

A suspected condition is one where the patient is predominantly concerned or believed in the persistence of a dominant physical illness (susceptible concept). As a result, the patient repeatedly sought medical treatment. Negative medical tests and doctors' explanations did not dispel his doubts. Even if the patient sometimes has some kind of physical disorder, it cannot explain the nature and extent of the symptoms reported, or the patient's concept of pain and advantage, often accompanied by anxiety or depression. Doubts or predominant perceptions of physical deformities (although insufficiently based) are also present. This disorder is common to both men and women, has no obvious family characteristics (unlike somatization disorder), and often has a chronic fluctuating course. The specific performance is as follows:

(1) Often caused by physical illness or mental stimulus, showing excessive concern for physical health or disease, and its severity is not commensurate with the actual health status. Patients feel distressed about a disease they think they have, rather than the consequences of the disease or secondary social effects.

(2) Often sensitive and suspicious, overly concerned about health, and requiring high personality characteristics, making suspected explanations of certain physiological phenomena and abnormal feelings (such as heartbeat, bloating, etc.) that occur daily.

(3) The patient's concept of suspected disease is very solid and lacks sufficient basis, but it is not delusion, because the patient urgently requires examination and treatment because he knows that his disease evidence is insufficient.

(4) The above manifestations of patients are different. If the suspected physical discomfort is obvious, those with anxiety or depression are called sensory suspected disorders. The concept of suspected disease is obvious, but the physical discomfort and the mood change are not obvious are called conceptual suspected disease. Suspected physical deformities are mainly seen in adolescents. Patients believe that their physical appearance, such as the nose and lips. There are serious defects that require orthopedic surgery, but this is far from the case. If such concepts are not shaken by the interpretation and have obvious emotional colors, they are not ridiculous in terms of the patient's cultural background and can be considered as a pathological overpriced concept. Patients pay great attention to various readings related to the disease, and often take the right seat after reading to strengthen the concept of suspected disease.

(5) Although repeated medical visits or medical examinations, negative results and reasonable explanations from doctors cannot dispel their doubts.

(6) The onset is usually slow, the course of the disease is continuous, and the symptoms are mild to severe, often leading to social dysfunction. Good prognosis is often related to the following factors: acute onset; associated with a physical disease; the course of disease within 3 years, no serious personality defects; no secondary benefits, etc.

4. Somatic form of autonomic dysfunction

The disorder is mainly manifested as a neurosis-like syndrome caused by a physical disorder in an organ system (such as cardiovascular, gastrointestinal, and respiratory systems) dominated by autonomic nerves. On the basis of autonomic nervous symptoms (such as palpitations, sweating, blushing, and tremor), the patient also developed non-specific, but more individual characteristics and subjective symptoms, such as pain in the area, burning sensation, heaviness, Tightness, swelling, examination of these symptoms can not prove physical disorders of the relevant organs and systems. This disorder is therefore characterized by significant autonomic involvement, non-specific symptoms with subjective complaints, and persistent blame for the symptoms on a particular organ or system. The specific clinical characteristics are as follows:

(1) Symptoms are caused by dysfunction of the organ system mainly or completely dominated and controlled by the autonomic nerve.

(2) The most common and prominent are those involving cardiovascular and other systems ("cardiac neurosis"), the respiratory system (hypergenic ventilating and coughing), and the gastrointestinal system ("gastric neurosis" and "neurological diarrhea" ).

(3) Symptoms are usually of two types: the first type is characterized by objective signs of autonomic nervous excitement, such as palpitations, sweating, blushing, and tremor; the second type is characterized by more individual specificity Sexual and subjective, and the symptoms themselves are non-specific, such as pain, burning, heaviness, tightness, swelling and so on.

(4) The patient attributes the symptoms to a specific organ or system (the same system as the autonomic symptoms). However, no evidence of organic lesions in organs and systems can be found for any type of symptoms.

(5) The characteristic clinical phase of this disease lies in the combination of the following three aspects: clear autonomic nerve involvement, non-specific subjective complaints, and patients insisting that they blame it on a specific organ or system.

(6) Many patients have psychological stress or difficulties and problems.

(7) Sometimes there may be mild disturbances in physiological functions, such as hiccups, flatulence, and excessive ventilation, but these themselves do not affect the basic physiological functions of the corresponding organs or systems.

5. Persistent somatic pain

The main manifestation of this disorder is a persistent, severe pain that cannot be reasonably explained by physiological processes or physical disorders. Emotional conflict or psychosocial problems directly lead to the occurrence of pain. After examination, no physical complaints were reported. The course of the disease is prolonged, often lasting more than 6 months, and the social function is impaired.

Somatoform disorder diagnosis

Somatization disorders are mainly characterized by various, recurrent, and frequently changing physical symptoms. After careful exploration, these symptoms are likely to be caused by the unpleasant mood caused by stress. Symptoms often exist for years before going to a psychiatric clinic. Most patients have had complicated experiences of long-term contact with grassroots and specialized health care facilities, during which many tests have been performed without positive findings or surgery. The diagnosis should be noted that there are various physical symptoms with various changes for at least 2 years, and no proper physical explanation has been found, and many doctors have continuously refused the advice and guarantee of no physical explanation for their symptoms. Symptoms and the behaviors they cause cause a degree of impairment of social and family functions.

Somatoform disorder treatment

Basic principles

Treatment of patients with somatoform disorders is difficult, and comprehensive treatment should be adopted.

(1) Psychotherapeutic patients often refuse to accept symptoms because the psychological possibility is the reason. Therefore, psychological therapy for the purpose of improving introspection can help patients explore and resolve the internal conflicts that cause symptoms. Once the inner conflict is resolved, the symptoms often disappear automatically. Of course, some patients have resistance to this treatment.

(2) Symptomatic treatment For those with obvious symptoms of anxiety and depression, appropriate anxiolytic and antidepressant treatment should be given; for certain physical symptoms, corresponding medical treatment can be given.

(3) Other biological feedback and other systemic relaxation treatment techniques can help patients relax and control anxiety and pain.

2. Treatment of somatoform disorders

(1) Psychotherapy Supportive psychotherapy provides patients with explanation, guidance, and dredging so that they can understand the knowledge of disease symptoms, which is effective for alleviating emotional symptoms and enhancing confidence in treatment. Psychodynamic Psychotherapy helps patients to explore and understand the inner psychological conflict behind the symptoms, which is effective for the complete relief of the symptoms. Cognitive therapy has a long-term effect on patients who have obvious concepts of suspected disease and have suspected personality. Morita therapy enables patients to understand that the symptoms are not serious, and adopts an attitude of accepting and tolerating the symptoms, and continues to work, study and live naturally, which is effective for alleviating the symptoms of the disease and improving the quality of life.

(2) Drug-treated patients have high health requirements and are sensitive to physical reactions. It is advisable to choose drugs with small adverse reactions, and it is advisable to use low-dose treatment. Those with obvious anxiety and depression symptoms can be given an appropriate amount of anti-anxiety drugs or antidepressants, often with an anxiolytic drug (alprazolam, laurazepam, clonazepam, etc.) in small doses effective. In addition, symptomatic treatment can be given for physical symptoms, such as propranolol and metoclopramide should be given in short courses.

(3) Others, such as spectrum therapy, massage therapy, external counterpulsation therapy, etc., have certain auxiliary treatment effects.