scholarly journals Somatoform and dissociative disorders: assessment and treatment

1997 ◽  
Vol 3 (1) ◽  
pp. 9-16 ◽  
Author(s):  
David Gill ◽  
Christopher Bass
Keyword(s):  
Somatoform Disorders ◽  
Physical Symptoms ◽  
Heterogeneous Group ◽  
Dissociative Disorders ◽  
Loss Of Function ◽  
Physical Disease ◽  
Assessment And Treatment ◽  
Icd 10

The category ‘somatoform disorders' was introduced comparatively recently in DSM–III and thereafter in ICD–10: it is the umbrella term currently favoured to cover a heterogeneous group of interrelated and overlapping syndromes, which have been given many names over the years. All these syndromes have in common the process of somatisation: that is, the presence of physical symptoms unexplained by physical disease, with variable degrees of distress and loss of function, about which the patient consults doctors.

scholarly journals ICD-10-Coding of Medically Unexplained Physical Symptoms and Somatoform Disorders—A Survey With German GPs

2021 ◽  
Vol 8 ◽  
Author(s):  
Nadine J. Pohontsch ◽  
Thomas Zimmermann ◽  
Marco Lehmann ◽  
Lisa Rustige ◽  
Katinka Kurz ◽  
...  
Keyword(s):  
Somatoform Disorders ◽  
Physical Symptoms ◽  
Simulated Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Response Options ◽  
Medically Unexplained Physical Symptoms ◽  
Icd 10 ◽  
Medically Unexplained ◽  
Unexplained Physical Symptoms

Background: General practitioners (GPs) are reluctant to use codes that correspond to somatization syndromes.Aim: To quantify GPs' views on coding of medically unexplained physical symptoms (MUPS), somatoform disorders, and associated factors.Design and Setting: Survey with German GPs.Methods: We developed six survey items [response options “does not apply at all (1)”—“does fully apply (6)”], invited a random sample of 12.004 GPs to participate in the self-administered cross-sectional survey and analysed data using descriptive statistics and logistic regression analyses.Results: Response rate was 15.2% with N = 1,731 valid responses (54.3% female). Participants considered themselves familiar with ICD-10 criteria for somatoform disorders (M = 4.52; SD =.036) and considered adequate coding as essential prerequisite for treatment (M = 5.02; SD = 1.21). All other item means were close to the scale mean: preference for symptom or functional codes (M = 3.40; SD = 1.21), consideration of the possibility of stigmatisation (M = 3.30; SD = 1.35) and other disadvantages (M = 3.28; SD = 1.30) and coding only if psychotherapy is intended (M = 3.39; SD = 1.46). Exposure, guideline knowledge, and experience were most strongly associated with GPs' self-reported coding behaviour.Conclusions: Subjective exposure, guideline knowledge, and experience as a GP, but no sociodemographic variable being associated with GPs' subjective coding behaviour could indicate that GPs offer a relatively homogeneous approach to coding and handling of MUPS and somatoform disorders. Strengthening guideline knowledge and implementation, and practise with simulated patients could increase the subjective competence to cope with the challenge that patients with MUPS and somatoform disorders present.

Idiopathic Physical Symptoms: A Common Manifestation of Psychiatric Disorders in Primary Care

CNS Spectrums ◽  
2006 ◽  
Vol 11 (3) ◽  
pp. 201-210 ◽  
Author(s):  
Javier I. Escobar ◽  
Angelica Dìaz-Martínez ◽  
Michael Gara
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Psychiatric Disorders ◽  
Somatoform Disorders ◽  
Common Mental Disorders ◽  
Psychiatric Patients ◽  
Physical Symptoms ◽  
Medical Specialties ◽  
Assessment And Treatment ◽  
Medically Unexplained

ABSTRACTWorldwide, patients with common mental disorders, such as depression and anxiety, have a tendency to present first to primary care exhibiting idiopathic physical symptoms. Typically, these symptoms consist of pain and other physical complaints that remain medically unexplained. While in the past, traditional psychopathology emphasized the relevance of somatic presentations for disorders, such as depression, in the last few decades, the “somatic component” has been neglected in the assessment and treatment of psychiatric patients. Medical specialties have come up with a variety of “fashionable” labels to characterize these patients and the new psychiatric nomenclatures, such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, attempt to classify these patients into a separate “somatoform disorders” category. These efforts fall short, and revisionists are asking altogether for the elimination of “somatoform disorders” from future nomenclatures.This review emphasizes the importance of idiopathic physical symptoms to the clinical phenomenology of many psychiatric disorders, offers suggestions to the diagnostic conundrum, and provides some hints for the proper assessment and management of patients with these common syndromes.

Medically unexplained physical symptoms - a multidisciplinary approach

2011 ◽  
Vol 26 (S2) ◽  
pp. 1573-1573
Author(s):  
V. Pais ◽  
D. Correia ◽  
F. Ramalho e Silva
Keyword(s):  
Multidisciplinary Approach ◽  
Somatoform Disorders ◽  
Physical Symptoms ◽  
Medically Unexplained Physical Symptoms ◽  
Daily Work ◽  
Medline Search ◽  
Effective Interventions ◽  
Medically Unexplained ◽  
Unexplained Physical Symptoms

BackgroundMedically unexplained physical symptoms (MUPS) can be defined as physical symptoms that have no currently known physical pathological cause. MUPS account for one in five new consultations in primary care and for one third of new patients when neurology consultations are considered.Patients with MUPS present significant distress and impaired function and their diagnosis is sometimes hard to establish. The classification of somatoform disorders has been found to be insufficiently useful for therapeutic and scientific purposes. Some authors suggest that new classifications should attend to clinical utility, defined as (1) the extent to which a diagnosis can help clinicians understand or conceptualize a disorder in their daily work; (2) the extent to which a diagnosis can help the clinician communicate useful information to others, including practitioners, family members, patients, and administrators; (3) the extent to which the presence of a disorder helps the clinician choose effective interventions, and (4) the extent to which a disorder can predict future clinical management needs.AimThis review aims to discuss the management of MUPS in mental health services, attending to the importance of a multidisciplinary approach.MethodsPubmed Medline search on MUPS and review of recent literature.DiscussionThe management of MUPS implies a multidisciplinary approach that can offer different solutions for different degrees of disorder severity and takes into account the perception of the patient about his own illness. New classifications of somatoform disorders that include comprehensible explanations about these symptoms could be helpful for patients and health professionals.

Psychiatric Consultation after Kidney Transplantation: A 10-Year Single-Center Study Including Outpatients in Japan

2012 ◽  
Vol 43 (3) ◽  
pp. 197-209 ◽  
Author(s):  
Katsuji Nishimura ◽  
Sayaka Kobayashi ◽  
Hiroko Sugawara ◽  
Ichiro Nakajima ◽  
Hideki Ishida ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Somatoform Disorders ◽  
Psychiatric Consultation ◽  
Single Center Study ◽  
Routine Clinical Setting ◽  
Patient Database ◽  
Icd 10 ◽  
Long Time ◽  
Psychiatric Intervention

Background: The aim of this study was to elucidate the clinical characteristics and frequency of psychiatric consultation in a routine clinical setting after kidney transplantation. Methods: Subjects were 1,139 consecutive recipients who received kidney transplantation at our hospital between January 1997 and September 2006. The hospital patient database was searched to determine whether these recipients received psychiatric consultation after their transplantation during this period. Results: Among 1,139 recipients, 118 (10%) received psychiatric consultation after their transplantation. There were significantly more women among these recipients ( p = 0.036). Many of the recipients had received psychiatric consultation before transplantation ( p < 0.0001) and had received dialysis for a long time ( p = 0.018). There were three main psychiatric diagnoses according to ICD-10 diagnostic criteria in these 118 recipients: 42 (36%) had neurotic, stress-related, and somatoform disorders (F4); 35 (30%) had organic, including symptomatic, mental disorders (F0); and 27 (23%) had mood (affective) disorders (F3). The median length of time between kidney transplantation and initial psychiatric consultation was 57 days (interquartile range: 10–650 days). The lengths were 7 days (6–17 days) for F0, 75 days (18–650 days) for F4, 243 days (35–1,004 days) for F3, and 253 days (10–1,393 days) for other diagnostic groups. Significant differences were observed among these four groups (Jonckheere-Terpstra test, p < 0.001). Conclusion: Our results show that appropriate psychiatric intervention is necessary not only in early stages after kidney transplantation but also over the long term.

Dynamics aspects in ex-combatants experienced PTSD

2011 ◽  
Vol 26 (S2) ◽  
pp. 1087-1087
Author(s):  
M. Tadevosyan ◽  
A. Babakhanya-Gambaryan
Keyword(s):  
Traumatic Stress ◽  
Somatoform Disorders ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Icd 10 ◽  
Post Traumatic ◽  
The One ◽  
Psychological Features ◽  
Level 2 ◽  
Observation Period

IntroductionGrowing stress and extreme situations create serious psychological problems, for solving which a person must get adopted to new situations different from stress- formed conditions, “suppressing” herewith spontaneous aggression and anxiety that quite often leads to both forming anti- and asocial behavior and the development of somatoform disorders.ObjectiveThe purpose of this study is to examine the development of several PTSD (post traumatic stress disorder) symptoms actual in PTSD dynamics.AimTo determine how growing of actual parameters impacts on development of PTSD.MethodsIn this study material of observation, testing and diagnoses of 30 male Karabagh war volunteers at the age of 35–61 (48 ± 8) were used. The psychiatric disorders (among the examined patients) corresponded to ICD-10 diagnostic criteria for PTSD. The observation period included 15–18 years. The clinical self- report scale SCL-90-R was used to assess several psychological features.ResultsAll the actual SCL-90 properties exceed the pathological level (≥2). In particular, somatisation level was 2, 2 ± 0, 5 in 2009 vs. 1, 97 ± 0,10 in 1996. It is caused, on the one hand, by the presence of unconscious suppressed anxiety, on the other hand, by the evident deterioration of the patients’ somatoneurological status. Besides, growing aggression is revealed (SCL- hostility) (2,4 ± 0,8 in 2009 vs. 2, 24 ± 0,16 in 1996), that indicates gradual forming of organic cerebral changes.ConclusionThe comparison of 1996–2009 features enables to hypothesize, that development of actual parameters is essential in PTSD dynamics at the stage of distant results.

Dissosiativ identitetsforstyrrelse i utredning av barn og ungdom: Teori og kliniske utfordringer

2021 ◽  
Vol 58 (8) ◽  
pp. 672-680
Keyword(s):  
Clinical Practice ◽  
Relevant Literature ◽  
Dissociative Disorders ◽  
Cognitive Difficulties ◽  
Dissociative Symptoms ◽  
Literature Searches ◽  
Adequate Understanding ◽  
Assessment And Treatment ◽  
Trauma Model ◽  
Practice Methods

Background: Clinical practice and recent research indicate that dissociative symptoms and disorders are left unidentified and undiagnosed by health professionals. Based on a clinical case from our work setting, this article describes relevant literature regarding dissociation and dissociative disorders to add to the knowledge of the theoretical and phenomenological features of complex dissociative disorders. Further, we describe differential diagnostic challenges that may arise in clinical practice. Methods: Both systematic and non-systematic literature searches were performed. Findings: Recent research shows the Trauma model to be central to understanding dissociative disorders. Symptoms can be mistaken for cognitive difficulties, oppositional issues or other somatic symptoms. Quantitative measures, systematic observations and clinical evaluations are fundamental for identifying dissociative symptoms and disorders. Implications: There is potential for identifying and evaluating dissociative symptoms at an earlier stage. Interdisciplinary and differential diagnostic evaluations are crucial to provide adequate understanding, assessment, and treatment of these patients. Keywords: Dissociative identity disorder, dissociation, somnambulism, biopsychosocial framework, clinical practice

Common Mental Disorders

2019 ◽  
pp. 31-56 ◽  
Author(s):  
R. Raguram
Keyword(s):  
Health Care ◽  
Mental Disorders ◽  
Somatoform Disorders ◽  
Common Mental Disorders ◽  
Adjustment Disorder ◽  
Emotional Symptoms ◽  
Co Morbidity ◽  
Wide Range ◽  
Icd 10 ◽  
High Degree

This chapter focuses on common mental disorders (CMDs). These disorders include a wide range of conditions that are frequently noticed in the community. It is essentially a convenient, functional grouping of conditions. The chapter analyses the trends on the basis of researches in this area over the past decade. The classification of CMDs for primary health care, according to ICD-10, includes depression, phobic disorder, panic disorder, generalized anxiety, mixed anxiety and depression, adjustment disorder, dissociative disorder, and somatoform disorders. Irrespective of the nature of the disorder, these patients often present with somatic complaints: some patients may admit to having emotional symptoms. It was observed that there is a high degree of co-morbidity among them, leading to significant levels of disability and increased health-care costs.

ICD-10/DSM-IV index

2013 ◽  
pp. 1023-1042
Keyword(s):  
Substance Abuse ◽  
Mental Disorders ◽  
Affective Disorders ◽  
Somatoform Disorders ◽  
Physical Factors ◽  
Psychoactive Substance ◽  
Adult Personality ◽  
Behavioural Syndromes ◽  
Icd 10 ◽  
Dsm Iv

F00-F09 Organic, including symptomatic mental disorders F10–F19 Mental and behavioural disorders due to psychoactive substance abuse F20–F29 Schizophrenia, schizotypal, and delusional disorders F30–F39 Mood (affective) disorders F40–F49 Neurotic, stress-related, and somatoform disorders F50–F59 Behavioural syndromes associated with physiological disturbance and physical factors F60–F69 Disorders of adult personality and behaviour...

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