Somatoform disorders are psychiatric rather than just physical conditions. This means that patients suffering from these disorders have some physical symptoms but the full extent of their medical condition may be described only using some psychiatric explanation. Different mood and anxiety disorders are very common causes of certain physical symptoms in these patients and the treatment of psychological symptoms usually improves patients’ physical condition.
How to Treat Somatoform Disorders?
Acute worsening of patients’ symptoms may bring them to emergency rooms, in order to be assessed and treated. Doctors usually perform necessary studies in order to rule out physical causes of patients’ symptoms. In some cases these might be appendicitis or myocardial infarction. Patients might need some sedation with oral or intravenous medications. However, long term use of benzodiazepines and both acute and chronic use of narcotic painkillers should be avoided in these patients.
Somatoform disorder patients suffering from depression may be treated with electroconvulsive therapy.
Conversion disorder is usually treated by ruling out all potential causes of life-threatening condition and some emotional support for patients’ family. Psychiatric consultation in early days may prevent unnecessary medical interventions and even surgical procedures.
Primary Care Management
Doctors’ education about somatization has been proven to be extremely valuable in the somatoform management, as well as strong relationship between the patient and his or her doctor. There should be some psychoeducation of the patient, informing him that emotional problems and anxiety may worsen their current condition and that the symptoms they have are not life threatening or severe in nature. Patients could be suggested the fact that some other people who had similar symptoms before experienced spontaneous improvement. These noninvasive treatments may decrease anxiety in somatoform disorder patients and limit health care for these patients.
Successful treatment usually involves psychosocial interventions and psychotherapy for high medical use and distress these patients feel.
Family members should advise somatoform disorder patients to consult their doctor and try not to be too involved in medical care or symptoms of their siblings.
Possible Psychosocial Interventions
There are several different somatoform disorders, such as pain disorder, conversion disorder, somatization disorder and hypochondriasis and all of them could be treated differently.
Pain disorder may be treated using behavior therapy or hypnosis, as well as with some individual psychotherapy. Conversion disorder may also be resolved using behavior therapy of hypnosis, but there are limited studies about effects of specific psychotherapies for this disorder. In some cases, symptoms may resolve without any treatment. Somatization disorder may be resistant to individual and group psychotherapy but if they accept this type of treatment it can be very helpful. Hypochondriasis can be helped through group psychotherapy, especially regarding anxiety and social support.