[Somatoform disorders in urology].
Explore the source record for details and available documents.
Diagnosis, Differential↗
SEARCH · PubMed Health
Results for “Somatoform Disorders”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Painful somatoform disorder and work incapacity].
Explore the source record for details and available documents.
Diagnosis, Differential↗
[Paranoid nosogenic reactions in patients with somatoform disorders].
The authors examined 16 patients with ischemic heart disease who had psychogenic disorders with ideas of rationalization of therapy. Paranoial personality disorders (paranoial psychopathy) was diagnosed in 11 patients, pseudopsychopathy in residual schizophrenia in 5 patients. The patients had either a fanatic idea of creating new methods of self-therapy and an autoaggressive behavior (performing some dangerous manipulations, usage of non-medicamentous substances, etc.). The premorbid state of such patients was characterized by inclination to paranoial reactions and a special predisposition to them combined with an egodystonic attitude to corporal manifestations. Paranoial reactions of such type were reversible and disappeared in the course of somatic state improvement.
Humans↗
Genetics of somatoform disorders.
I investigated the contribution of hereditary factors in somatoform disorders. Fourteen monozygotic and 21 dizygotic index twins and their co-twins were personally interviewed. The results showed a concordance of 29% in monozygotic and 10% in dizygotic pairs. However, similarity in childhood experience seemed to influence the concordance rates. Thus, even if somatoform disorders appear familial, the transmission may be environmental. Furthermore, the study showed a high frequency of anxiety disorders, especially generalized anxiety disorders, in the co-twins of somatoform-disordered twins.
Adult↗
Why do doctors dislike treating people with somatoform disorder?
OBJECTIVE: To consider the question of why doctors dislike treating people with somatoform disorder, with a view to assisting debate and improving services. METHODS: The literature was examined, and compared with clinical experience. RESULTS: Psychological, sociological and evolutionary theory make relevant contributions. Important factors include that these conditions are problematic and positive outcomes may not be possible given current knowledge and clinical skills and techniques. Patients may not accept that their problem is a form of psychiatric or brain disorder. Most importantly, the doctor may not accept that somatoform disorders are beyond the control of patients, setting the scene for irritation and unsatisfactory interactions. CONCLUSIONS: There are many factors that underlie the dislike of some doctors for treating people with somatoform disorder. There is a pressing need for educational efforts to help students and doctors accept that the symptoms of somatoform disorder are beyond the control of those who suffer them.
Attitude of Health Personnel↗
Specific somatoform disorder in the general population.
The authors assessed the validity of the recently proposed diagnosis for specific somatoform disorder in the general population. German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 individuals. Multivariate analyses were used to compare impairment, life satisfaction, and use of health care. A total of 803 of 4075 subjects (19.7%) with undifferentiated somatization disorder were identified, which included 51 subjects (1.3%) who met criteria for specific somatoform disorder. Subjects with specific somatoform disorder were more impaired, had lower life satisfaction, and had higher use of health care than subjects with undifferentiated somatization disorder only. The proposed diagnosis of specific somatoform disorder demonstrated a high validity independent of comorbid depressive and anxiety disorders.
Activities of Daily Living↗
The impact of cognitions on the development of panic and somatoform disorders: a prospective study in patients with vestibular neuritis.
BACKGROUND: There is a high incidence of panic and somatoform disorders after vestibular neuritis. However, the occurrence of psychiatric disorders has been shown to be unrelated to persistent functional vestibular impairment. The aim of the present study was to examine the role played by cognitions in the development of panic and somatoform disorders. METHOD: In a 2-year prospective study, cognitions were recorded at various stages using the Agoraphobic Cognitions Questionnaire and Body Sensations Questionnaire. Our analysis focused on whether body-related anxiety or panic-related thoughts can predict the development of a panic or somatoform disorder. RESULTS: Fear arising on the first day of an acute vestibular episode did not predict the development of panic or somatoform disorders. One week after the dysfunction, however, the fear of vertigo was a significant predictor, explaining 20% of the variance in the development of either disorder. After 6 weeks, persistent fear of vertigo or vomiting predicted approximately 30% of the variance, and after 6 months panic-related thoughts predicted 40% of the variance and, with the inclusion of body-related fears, as much as 60% of the variance in the development of panic or somatoform disorders. CONCLUSION: Our data confirm prospectively a number of fundamental assumptions of cognitive theory concerning the development of anxiety disorders. Subjects who experience vertigo as particularly alarming focus more intensely than other patients on the negative symptoms they perceive as being related to the disorder. Patients with panic-related cognitions were prone to develop panic or somatoform disorders.
Acute Disease↗
Somatoform disorders: time for a new approach in DSM-V.
OBJECTIVE: DSM-III introduced somatoform disorders as a speculative diagnostic category for somatic symptoms "not explained by a general medical condition." Although retained and enlarged in DSM-IV, somatoform disorders have been the subject of continuing criticism by both professionals and patients. The extended period of preparation for DSM-V offers an important opportunity to reconsider the category of somatoform disorders. METHOD: Exploration of the diverse aims of a diagnostic classification indicates that the authors must not only address the conceptual and practical problems associated with this category but also reconcile it with the parallel medical descriptive classification of functional symptoms and syndromes. RESULTS: The existing somatoform disorders categories require modification. The authors favor the radical option of the abolition of the categories. Diagnoses currently within somatoform disorders could be redistributed into other groupings, and the disorders currently defined solely by somatic symptoms could be placed on axis III as "functional somatic symptoms and syndromes." Greater use could be made of "psychological factors affecting medical condition" on axis I. The authors suggest supplementing the diagnosis of functional somatic symptoms with a multiaxial formulation. CONCLUSIONS: The authors promote a classification of somatic symptoms in DSM-V that is compatible with that used in general medicine and offers new opportunities both for research into the etiology and treatment of symptoms and for the greater integration of psychiatry into general medical practice.
Attitude of Health Personnel↗
Treatment of somatoform disorders with St. John's wort: a randomized, double-blind and placebo-controlled trial.
OBJECTIVE: To investigate efficacy and safety of St. John's wort (SJW) LI 160 in somatoform disorders. METHODS: In a prospective, randomized, placebo-controlled, and double-blind parallel group study, 184 outpatients with somatization disorder (ICD-10 F45.0), undifferentiated somatoform disorder (F45.1), and somatoform autonomic dysfunction (F45.3), but not major depression, received either 300 mg of SJW extract LI 160 twice daily or matching placebo for 6 weeks. Six outcome measures were evaluated as a combined measure by means of the Wei Lachin test: Somatoform Disorders Screening Instrument--7 days (SOMS-7), somatic subscore of the HAMA, somatic subscore of the SCL-90-R, subscores "improvement" and "efficacy" of the CGI, and the global judgment of efficacy by the patient. RESULTS: In the intention to treat population (N=173), for each of the six primary efficacy measures as well as for the combined test, statistically significant medium to large-sized superiority of SJW treatment over placebo was demonstrated (p <.0001). Of the SJW patients, 45.4% were classified as responders compared with 20.9% with placebo (p =.0006). Tolerability of SJW treatment was equivalent to placebo. CONCLUSIONS: Administration of 600 mg of SJW extract LI 160 daily is effective and safe in the treatment of somatoform disorders, thereby confirming results from a previous study.
Adolescent↗
Somatoform disorders in neurological practice.
PURPOSE OF REVIEW: Patients with medically unexplained symptoms continue to intrigue, fascinate and frustrate clinicians. They are common in general medicine and often present with apparent neurological disorder. This review aims to provide insight into the recent literature that has sought to clarify epidemiology, diagnostic issues, aetiologic understanding and treatment of patients with psychogenic disorders who usually first present to neurologists. RECENT FINDINGS: Somatoform disorders are common in neurological practice. A number of papers have addressed issues of epidemiology and identified that medically unexplained symptoms in neurological populations are higher than originally thought. A number of recent review papers have served to summarize areas of considerable information (e.g. treatments) and areas of rapid growth in knowledge (e.g. neuroimaging). Studies investigating the role of psychological factors are well represented and clarify our psychopathological understanding of somatoform disorders in patients presenting to neurologists. Treatment studies are few and continue to be limited by population sizes and study designs. SUMMARY: Somatoform disorders are common in neurological populations. Comorbidity related to somatoform disorders with known organic neurological conditions requires further study. On account of the limitations of treatment studies, evidence-based clinical management of these patients is awaited.
Conversion Disorder↗
Can rt-PA be administered to the wrong patient? Two patients with somatoform disorder.
BACKGROUND: Intravenous rt-PA (i.v. rt-PA) for acute stroke has raised many concerns, including its inadvertent use in patients presenting with acute stroke-like symptoms as the expression of their somatoform disorder. Diagnosis of the somatoform disorder is often delayed, and thrombolytics in these patients for their stroke-like presentation subjects them to risk for hemorrhage. METHODS: The presentation, neurological findings, and the therapeutic decision making was audited in 85 patients who received i.v. rt-PA for a diagnosis of acute stroke. All the surviving patients were re-examined neurologically at least three months after i.v. rt-PA. Baseline and follow-up brain CT scans were re-reviewed by a neuroradiologist who was blinded to clinical presentation and outcome. Patients whose clinical presentation, brain CT and neurological outcome did not fit into known or expected anatomical and clinical patterns of stroke underwent psychological assessment using the Minnesota Multiphasic Personality Inventory-2. RESULTS: In two patients three stroke-like presentations of somatoform disorder inadvertently were treated with i.v. rt-PA. This was primarily caused by abbreviated neurological examination and narrow differential diagnosis. INTERPRETATION: Patients with somatoform disorder may present with symptoms mimicking acute stroke. Under the time constraints of i.v. rt-PA use, a diagnosis of somatoform disorder can be missed, subjecting such patients to the potential complications of thrombolytics.
Acute Disease↗
Behavioral medicine approaches to somatoform disorders.
This article reviews the research evidence for the efficacy of cognitive-behavioral therapy (CBT) for somatoform disorders. Randomized controlled studies support the efficacy of individual CBT for the treatment of hypochondriasis, body dysmorphic disorder (BDD), and undifferentiated somatoform disorders including medically unexplained symptoms, chronic fatigue syndrome, and noncardiac chest pain, and group CBT for the treatment of BDD and somatization disorder. On the basis of this review of the existing research and a theoretical model of the processes involved in somatoform disorders, the authors offer suggestions for future research and effective treatment.
Behavioral Medicine↗
[Somatoform disorders in general practice: prevalence, functional limitations and comorbidity with anxiety and depression].
OBJECTIVE: To quantify the prevalence of, and functional impairment associated with, somatoform disorders in general practice and their comorbidity with anxiety and depression. DESIGN: Prevalence study. METHOD: In the first phase of a two-stage prevalence study from April 2000 up to December 2001, a questionnaire was completed by 1046 consecutive attendees at general practices, aged 25-79 years (n = 1778). This was followed in the second phase by a standardised diagnostic interview ('Schedules for clinical assessment in neuropsychiatry'; SCAN 2.1) in a stratified sample of 473 patients. In the analyses, the prevalence figures were estimated by weighting back to the original attending population. RESULTS: The prevalence ofsomatoform disorders was 16% (95% CI: 12.8-19.4). Comorbidity of somatoform disorders and anxiety or depression disorders was 3.3 times more likely than would be expected by chance. Somatoform disorders as well as anxiety or depressive disorders were associated with substantial functional impairment. In patients with comorbid disorders, physical symptoms, depressive symptoms and functional limitations were proportionately increased. CONCLUSION: These findings underline the importance of a comprehensive diagnostic approach covering anxiety and depressive disorders as well as somatoform disorders in general practice.
Adult↗
[From perception to symptom--from symptom to diagnosis. Somatoform disorders as a communication phenomenon between physician and patient].
Patients with somatoform disorders probably constitute the largest diagnostic group in daily medical practice. A major communication problem forms the core of somatoform disorders: patients report about complaints which their physicians do not understand; there is no sufficient biological reason for the patient's symptoms. This article discusses the multifactorial origin of somatoform disorders, consisting of minimal physiological changes, the perception of bodily sensations, and their interpretation as symptoms (non-normal perceptions), as well as ensuing emotional and behavioral consequences. Concerning the communication problem, it is important to realize that patients normally present symptoms, whereas the underlying bodily perceptions and the explanatory models are rarely communicated to the physician. On the physician's side, symptoms presented by patients are subjected to his or her explanatory concepts translating symptoms into indicators of certain diseases. Thus, the information introduced into physician-patient communication by the patient has usually passed several cognitive circuits within the patient or between the patients and other significant conversation partners thus shaping its specific components. It is recommended that physicians try to trace back their patients' symptoms to bodily sensations and explanatory models in order to base their diagnostic and therapeutic reasoning on the same kind of information. Empirical evidence is presented to support the inter-dependence of the components of the model, on both the patient's and the physician's side. Therapeutic interventions based upon the model are presented.
Awareness↗
[Observation on clinical therapeutic effects of electroacupuncture combined with moving cupping on somatoform disorders].
OBJECTIVE: To observe therapeutic effect of electroacupuncture combined with moving cupping therapy on somatoform disorders. METHODS: Twenty-five cases of somatoform disorders meeting CCMD-3 criteria were treated with electroacupuncture and moving cupping for 4 therapeutic courses (20 sessions), and the improvement of symptoms and therapeutic effect were observed after treatment. RESULTS: After treatment, of the 25 cases, 13 were markedly effective, 9 improved and 3 ineffective, the total effective rate being 88.0%; the score of SCL-90 factor decreased significantly (P < 0.05). CONCLUSION: Electroacupuncture combined with moving cupping therapy can early control target symptoms and improve bad emotion for the patient of somatoform disorders.
Acupuncture Points↗
St John's wort extract (LI 160) in somatoform disorders: results of a placebo-controlled trial.
RATIONALE AND OBJECTIVE: Preliminary data have shown that St John's wort might possess some specific efficacy in patients with somatoform complaints. Therefore, the efficacy of the Hypericum extract LI 160 in patients with somatoform disorders should be studied in a double-blind placebo-controlled fashion. METHODS: This was a multicentre, randomised, placebo controlled, 6-week trial comparing the efficacy of LI 160 (600 mg/day) and placebo in 151 out-patients suffering from somatization disorder (ICD-10: F45.0), undifferentiated somatoform disorder (F45.1), or somatoform autonomic dysfunctions (F45.3). The primary outcome measure was the decrease of the Hamilton Anxiety Scale, subfactor somatic anxiety (HAMA-SOM), during the trial period. RESULTS: LI 160 was superior effective concerning the primary outcome criterion HAMA-SOM [decrease from 15.39 (SD 2.68) to 6.64 (4.32) in the Hypericum group and from 15.55 (2.94) to 11.97 (5.58) in the placebo group (statistically significant difference, P=0.001)]. This was corroborated by the result of a statistically significant superior efficacy in the outcome criteria additionally used such as Clinical Global Impression, HAMA-total score, HAMA, subscore psychic anxiety, Hamilton Depression Scale, Self-Report Symptom Inventory 90 items - revised (SCL-90-R), and SCL-90-R, subscore somatic anxiety. The efficacy of LI 160 was preserved after splitting the population in those with and those without mild depressive symptoms [corrected]. Tolerability of LI 160 was excellent. CONCLUSION: The data from this trial show excellent efficacy and tolerability for LI 160 in somatoform disorders. The efficacy is independent of an existing depressive mood. This is the first study showing the efficacy of a drug in patients with somatisation disorder independent of depressive symptomatology.
Adolescent↗
Rethinking somatoform disorders.
PURPOSE OF REVIEW: From the very moment of their inclusion in contemporary classification systems in psychiatry, the concept of somatization and diagnostic categories of somatoform disorders became a matter of controversy that created an ongoing debate about their validity, reliability and applicability in clinical and research settings. The aim of this review is to provide an insight into the current theoretical, research and clinical dilemmas in the area of somatoform disorders and to illustrate them with brief summaries of scientific papers recently published in this field. RECENT FINDINGS: In the period covered by this review, the most valuable scientific contributions to the current state of knowledge on somatoform disorders were (surprisingly numerous) review papers produced by the leading experts in this field. These comprehensive and critical meta-analyses covered historical, conceptual, epidemiological and cross-cultural aspects of somatoform disorders. Another and a relatively smaller group of recently published papers reported on some novel treatment strategies for patients with specific somatoform disorders, their service utilization and health care-related costs. SUMMARY: If one were to find a common denominator of the papers covered by this review, it is a general agreement amongst their authors that the current concepts of somatization and somatoform disorders have serious theoretical and practical limitations in both research and clinical settings. They suggest that the time has come to seriously rethink these concepts so as to find better nosological solutions for the forthcoming revisions of classification systems in psychiatry and medicine.
Journal Article↗
Somatoform disorders in children and adolescents.
Somatization is common among children and adolescents. A consecutive series of 112 children and adolescents who fulfilled the ICD-10 clinical diagnostic criteria for somatoform disorders attended at a psychiatric consultation center were included in this study to delineate the pattern of presenting features and to find out associated abnormal psychosocial situations and disabilities. Out of 112 cases 52 were boys, 60 girls, of them 59 were children and 53 adolescents. Polysymptomatic presentation was commoner (92%) than monosymptomatic presentation (8%). Pain was the most prevalent symptom. Children showed significantly higher rates of abdominal complaints and adolescents showed higher rates of headaches. All cases reported an average of 14.21 somatic symptoms. Boys and girls reported an average of 13.75 and 14.61 somatic symptoms respectively and this difference between two groups was not significant. Whereas children reported an average of 12.66 somatic symptoms and adolescents reported an average of 15.94 somatic symptoms. The difference was significant. Differences were also found in the diagnostic categories of somatoform disorders. Girls reported higher rates of somatization disorder and persistent somatoform pain disorder than that of boys. Children reported higher rates of undifferentiated somatoform disorder and somatoform autonomic dysfunction. In contrast, adolescents reported higher rates of somatization disorder. Abnormal psychosocial situations were found to be associated with predisposition, onset, and course of the disorders in majority of the cases and most common was parental overprotection. Remarkable social impairments particularly, in the domains of academic and peer relationship were found among the cases. Findings suggest that somatoform disorders in children and adolescents are frequent in clinical practice. Better understanding of these disorders can promote early diagnoses and timely treatments and improve the quality of life by preventing negative consequences.
Adolescent↗