[Diagnosis and treatment of somatoform disorders (functional physical complaints)].
In modern classification systems, unexplained physical symptoms without an organic origin are labelled "somatoform disorders". This syndrome is very frequent and causes a lot of treatment costs as well as indirect costs (such as workers' compensation and others). In the past, effective treatment strategies were lacking. However, consideration of modern scientific results has made it possible to develop treatment approaches which find the acceptance of the patients and which are highly effective. A hierarchical approach is presented suggesting the following steps: a) Primary care: The consideration of management rules in primary care can prevent the chronicity of somatoform symptoms. b) Brief psychological and psychopharmacological treatments: Modern cognitive-behavioural approaches can help to cope with the symptoms and to improve the subjective well-being. First results for pharmacological treatments are encouraging. c) Integrative inpatient treatment including intense psychotherapeutic and psychosomatic ingredients. Experts' judgements of course and prognosis in somatoform disorders should consider the following features: Duration and multiplicity of the complaints; comorbidity with other psychiatric and physical disorders; disability in different areas of life such as at work, family, leisure time; individual coping strategies; treatment approaches in the past.
Medizinisch-Psychosomatischen Klinik Roseneck, Prien am Chiemsee.
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Fichter
D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D010348:Patient Care Team; D011320:Primary Health Care; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy