What is the most important target for treatment in somatic symptom disorder?
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Conversion disorder and somatic symptom disorder are both categorized as somatic symptom and related disorders (previously termed somatoform disorders). Show Somatic symptom and related disorders are psychiatric conditions where patients experience distressing physical symptoms associated with abnormal thoughts, feelings, and behaviors in response to these symptoms. They may result from psychological stress that is unconsciously (without awareness) expressed somatically, though the underlying cause is not fully understood. Risk factors include being female, having a history of abuse or adverse childhood events, and having personality traits of alexithymia (difficulty expressing emotions) or neuroticism. Symptoms that persist with an external focus of control, and without awareness of the psychological and stress-related interplay, can lead to considerable functional impairment and distress. Diagnosis is made by clinical interview, behavioral observation, physical exam suggestive of pseudoneurologic causes, and tests to rule out medical or neurologic causes. The diagnosis should not be made solely on the basis of medically unexplained symptoms; rather, it should be based on evidence from the clinical exam and the patient’s abnormal thoughts, feelings, and behaviors in response to the medically unexplained symptoms. Good doctor-patient relationships and validation of the patient's suffering are essential for effective management. Treatment includes cognitive behavioral therapy, physical therapy, and avoiding unnecessary medicines, tests, and procedures. Diagnosis and treatment of associated comorbid psychiatric conditions benefit overall functioning and recovery. Long-term management involves interrupting perpetuating factors, maintaining the same doctor, and providing strategies for self-efficacy, distress tolerance, coping, and modulating the interaction of anxiety, stress, and physical symptoms. Conversion disorder and somatic symptom disorder are psychiatric conditions that fall under the somatic symptom and related disorders category of the DSM-5-TR (previously termed somatoform disorders). Somatic symptom and related disorders are those with prominent physical symptoms associated with significant distress and impairment of function. Conversion disorder is characterized by voluntary motor or sensory function deficits that suggest neurologic or medical conditions but are rather associated with clinical findings that are not compatible with such conditions. Somatic symptom disorder is characterized by one or more somatic symptoms that are distressing or result in significant disruption of daily life. To meet DSM-5-TR criteria, these patients must have excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following: disproportionate and persistent thoughts about the seriousness of one’s symptoms; persistently high levels of anxiety about health or symptoms; excessive time or energy devoted to these symptoms or health concerns. Importantly, even if any one somatic symptom is not continuously present, the state of being symptomatic is persistent (typically more than 6 months).
Under a Creative Commons license Open access Highlights• Patients with somatic symptom disorder are a heterogeneous group. •Clinicians yielded a wide variety of treatment goals and influencing factors. •Treatment goals and influencing factors reflected distinct paradigmatic backgrounds. •The hierarchically structured overviews can be used to define treatment goals. They can also be used to monitor and evaluate change in outcomes. AbstractObjectiveOverviews of treatment goals and influencing factors may support shared decision making and optimize customized treatment to the patient with somatic symptom disorder (SSD). The aim of this study was to identify and structure comprehensive sets of treatment goals and factors influencing goal attainment in patients with SSD from the perspective of clinicians. MethodsUsing a concept mapping procedure, clinicians participated in interviews (N = 17) and card sorting tasks comprising 55 treatment goals and 55 factors influencing goal attainment (N = 38). ResultsWe identified four overarching categories (A to D) of nine clusters (1 to 9) of treatment goals: A. empowerment (A1. personal values, A2. committed action, A3. self-esteem), B. skill improvement (B4. interpersonal skills, B5. emotion and stress regulation), C. symptom reduction (C6. dysfunctional beliefs, C7. somatic symptoms, C8. psychological symptoms), and D9. active and structured lifestyle. Also, we identified four overarching categories (A to D) of nine clusters (1 to 9) of factors influencing goal attainment: A1. therapeutic alliance, B. social and everyday context (B2. [family] system, B3. meaningful daily schedule, B4. social and economic circumstances), C. ability to change (C5. externalizing tendency, C6. reflective and psychological skills, C7. perspective and motivation), and D. psychological vulnerability (D8. vulnerable personality, D9. [psychiatric] comorbidity). ConclusionThe overviews of treatment goals and factors influencing goal attainment reflect different paradigmatic backgrounds of clinicians. The results can be used, in combination with the perspective of the patient, to define treatment goals, and to monitor and evaluate change in outcomes. KeywordsClinician perspective Personalized medicine Shared decision making Somatic symptom disorder Somatoform disorder Treatment outcome Cited by (0)© 2022 The Authors. Published by Elsevier Inc. What is the most effective treatment for somatic symptom disorder?Cognitive behavior therapy and mindfulness-based therapy are effective for the treatment of somatic symptom disorder.
What is the important factor in diagnosing somatic symptom disorder?For somatic symptom disorder, more important than the specific physical symptoms you experience is the way you interpret and react to the symptoms and how they impact your daily life.
Which type of medication would be most effective at treating somatoform disorders?All classes of antidepressants seem to be effective against somatoform and related disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder (BDD), and SNRIs appear to be more effective than other antidepressants when pain is the predominant symptom.
How is somatic pain treated?Doctors will often use drugs to treat somatic pain. Over-the-counter medications you can take include: NSAIDs, such as aspirin, naproxen (Aleve), and ibuprofen (Advil) acetaminophen (Tylenol). baclofen.. cyclobenzaprine (Flexeril). metaxalone.. opioids, including hydrocodone and oxycodone.. |
