Recent Developments on Psychological Factors in Medically Unexplained Symptoms and Somatoform Disorders

Overview

Journal Front Public Health

Specialty Public Health

Date 2022 Nov 21

PMID 36408051

Authors

Ricarda Mewes

Affiliations

Soon will be listed here.

Abstract

Somatic symptoms which are not fully explained by a medical condition (medically unexplained symptoms) have a high relevance for the public health. They are very common both in the general population and in patients in health care, and may develop into chronic impairing conditions such as somatoform disorders. In recent years, the relevance of specific negative psychological factors for the diagnosis and the stability of somatoform disorders and for the impairment by medically unexplained symptoms gained more and more attention. This resulted-among others- in core changes in the diagnostic classification criteria of somatoform disorders. Against this background, the present "Perspective" will outline recent developments and findings in the area of medically unexplained somatic symptoms and somatoform disorders. Moreover, it will lay a special focus on evidence on specific negative psychological factors that may influence the course of unexplained somatic symptoms and disorders and the impairment caused by these symptoms.

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References

Lowe B, Mundt C, Herzog W, Brunner R, Backenstrass M, Kronmuller K . Validity of current somatoform disorder diagnoses: perspectives for classification in DSM-V and ICD-11. Psychopathology. 2007; 41(1):4-9. DOI: 10.1159/000109949. View

Rief W, Burton C, Frostholm L, Henningsen P, Kleinstauber M, Kop W . Core Outcome Domains for Clinical Trials on Somatic Symptom Disorder, Bodily Distress Disorder, and Functional Somatic Syndromes: European Network on Somatic Symptom Disorders Recommendations. Psychosom Med. 2017; 79(9):1008-1015. DOI: 10.1097/PSY.0000000000000502. View

Hung C, Liu C, Yang C . Persistent depressive disorder has long-term negative impacts on depression, anxiety, and somatic symptoms at 10-year follow-up among patients with major depressive disorder. J Affect Disord. 2018; 243:255-261. DOI: 10.1016/j.jad.2018.09.068. View

Dessel N, van der Wouden J, Twisk J, Dekker J, van der Horst H . Predicting the course of persistent physical symptoms: Development and internal validation of prediction models for symptom severity and functional status during 2 years of follow-up. J Psychosom Res. 2018; 108:1-13. DOI: 10.1016/j.jpsychores.2018.02.009. View

Edwards R, Cahalan C, Calahan C, Mensing G, Smith M, Haythornthwaite J . Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011; 7(4):216-24. DOI: 10.1038/nrrheum.2011.2. View

Mergl R, Seidscheck I, Allgaier A, Moller H, Hegerl U, Henkel V . Depressive, anxiety, and somatoform disorders in primary care: prevalence and recognition. Depress Anxiety. 2006; 24(3):185-95. DOI: 10.1002/da.20192. View

Barsky A, Orav E, Bates D . Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry. 2005; 62(8):903-10. DOI: 10.1001/archpsyc.62.8.903. View

Abbass A, Town J, Holmes H, Luyten P, Cooper A, Russell L . Short-Term Psychodynamic Psychotherapy for Functional Somatic Disorders: A Meta-Analysis of Randomized Controlled Trials. Psychother Psychosom. 2020; 89(6):363-370. DOI: 10.1159/000507738. View

Barends H, Dessel N, van der Wouden J, Twisk J, Terluin B, van der Horst H . Impact of symptom focusing and somatosensory amplification on persistent physical symptoms: A three-year follow-up study. J Psychosom Res. 2020; 135:110131. PMC: 7614434. DOI: 10.1016/j.jpsychores.2020.110131. View

10.

Rief W, Mewes R, Martin A, Glaesmer H, Brahler E . Evaluating new proposals for the psychiatric classification of patients with multiple somatic symptoms. Psychosom Med. 2011; 73(9):760-8. DOI: 10.1097/PSY.0b013e318234eff6. View

11.

Huang W, Chen I, Chang F, Liao S . Somatic symptom disorder and undifferentiated somatoform disorder, which is broader? Response to "Clinical value of DSM IV and DSM 5 criteria for diagnosing the most prevalent somatoform disorders in patients with medically unexplained physical.... J Psychosom Res. 2016; 89:114-5. DOI: 10.1016/j.jpsychores.2016.07.014. View

12.

Pacak K, Palkovits M . Stressor specificity of central neuroendocrine responses: implications for stress-related disorders. Endocr Rev. 2001; 22(4):502-48. DOI: 10.1210/edrv.22.4.0436. View

13.

Jacobs N, Myin-Germeys I, Derom C, Delespaul P, van Os J, Nicolson N . A momentary assessment study of the relationship between affective and adrenocortical stress responses in daily life. Biol Psychol. 2006; 74(1):60-6. DOI: 10.1016/j.biopsycho.2006.07.002. View

14.

Rief W, Hennings A, Riemer S, Euteneuer F . Psychobiological differences between depression and somatization. J Psychosom Res. 2010; 68(5):495-502. DOI: 10.1016/j.jpsychores.2010.02.001. View

15.

Klaus K, Fischer S, Doerr J, Nater U, Mewes R . Classifying Fibromyalgia Syndrome as a Mental Disorder?-An Ambulatory Assessment Study. Int J Behav Med. 2016; 24(2):230-238. DOI: 10.1007/s12529-016-9603-6. View

16.

Myin-Germeys I, Klippel A, Steinhart H, Reininghaus U . Ecological momentary interventions in psychiatry. Curr Opin Psychiatry. 2016; 29(4):258-63. DOI: 10.1097/YCO.0000000000000255. View

17.

Martin A, Rief W . Relevance of cognitive and behavioral factors in medically unexplained syndromes and somatoform disorders. Psychiatr Clin North Am. 2011; 34(3):565-78. DOI: 10.1016/j.psc.2011.05.007. View

18.

van Gils A, Burton C, Bos E, Janssens K, Schoevers R, Rosmalen J . Individual variation in temporal relationships between stress and functional somatic symptoms. J Psychosom Res. 2014; 77(1):34-9. DOI: 10.1016/j.jpsychores.2014.04.006. View

19.

van Eck van der Sluijs J, Have M, de Graaf R, Rijnders C, van Marwijk H, van der Feltz-Cornelis C . Predictors of Persistent Medically Unexplained Physical Symptoms: Findings From a General Population Study. Front Psychiatry. 2018; 9:613. PMC: 6262298. DOI: 10.3389/fpsyt.2018.00613. View

20.

McFarlane A, Ellis N, Barton C, Browne D, Van Hooff M . The conundrum of medically unexplained symptoms: questions to consider. Psychosomatics. 2008; 49(5):369-77. DOI: 10.1176/appi.psy.49.5.369. View