The connection between the human body and mind is both profound and complex. Each can impact the other, shaping our overall health and well-being. Somatic symptoms exemplify this connection, highlighting conditions where physical symptoms, often distressing, emerge without a clear medical cause but are deeply rooted in psychological factors. These disorders challenge the conventional boundaries of physical and mental health, emphasizing the need for a comprehensive understanding and approach to patient care.
In this chapter, we will provide a detailed examination of these disorders, focusing on their diagnostic criteria, potential triggers, and recommended interventions. By understanding these disorders, healthcare professionals can better address the needs of patients, ensuring holistic care that recognizes the powerful interplay between the mind and body.
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Somatic symptom disorder
- Characterized by one or more somatic symptoms for 6 or more months that cause significant distress or functional impairment.
- Brief somatic symptom disorder: Same symptoms of somatic symptom disorder but symptoms last less than 6 months.
- Patients experience excessive thoughts, feelings, or behaviors related to somatic symptoms or health concerns.
- Onset is typically in adolescence or early adulthood
- Associated with increased healthcare utilization, frequent medical appointments and tests, and dissatisfaction with medical care.
- Treatment:
- Cognitive-behavioral therapy (CBT)
- Acceptance and commitment therapy (ACT)
- Psychodynamic therapy
- Stress management.
- Regular visits with a physical exam could be beneficial.
Illness anxiety disorder
- Previously known as hypochondriasis
- Presents with a preoccupation with having or acquiring a serious illness, despite a lack of somatic symptoms or only mild symptoms.
- Brief illness anxiety disorder: Same symptoms of illness anxiety disorder but symptoms last less than 6 months.
- Patients have a high level of anxiety about health and excessive health-related behaviors or avoidance of healthcare.
- Onset is typically in early adulthood
- Risk factors include: History of childhood abuse, neglect, or significant trauma and family history of somatic-related disorders.
- Differential diagnosis: Somatic symptom disorder, generalized anxiety disorder, panic disorder, major depressive disorder, delusional disorder.
- Treatment: CBT, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
- Schedule regular follow-up appointments to address concerns, provide reassurance, and monitor progress
- Avoid excessive medical testing or referrals, as they may reinforce health anxiety
