title: [Case report of an elderly woman who developed a pain disorder following her husband's death].
abstract: We present the case of an elderly woman who developed a pain disorder following her husband's death. This patient consulted two or three gynecology clinics with anxiety due to external genital pain, the cause of which could not be identified. Subsequently, the patient came to our university hospital where she was diagnosed with "pain disorder" and "depression" by a psychiatrist. With medication and supportive psychotherapy, the patient showed positive clinical progress. The operational diagnosis of pain disorder was useful as it permitted the establishment of a diagnosis for a patient with pain, the cause of which could not be identified. In this case, the patient's external genital pain was thought to be a symptom of her loss of sexual identity and her depression following the death of her husband. It has been reported that such somatic pain appears when the patient does not mourn, leading to pathological symptons. Therefore, in supportive psychotherapy, it is important to listen carefully to the patients' complaints about their pain in order to provide them with the opportunity to finish grieving. As a complementary therapy to SSRI medication, supportive psychotherapy contributed strongly to this case's recovery.
authors.affiliation: Kamiamakusa City Municipal Clinic of Kyoragi.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Onishi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Abe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kato
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage; D003643:Death; D003863:Depression / Q000209:etiology / Q000523:psychology / Q000628:therapy; D005260:Female; D005836:Genitalia, Female; D006801:Humans; D008016:Life Change Events; D017374:Paroxetine / Q000008:administration & dosage; D011613:Psychotherapy / Q000379:methods*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage; D013001:Somatoform Disorders / Q000209:etiology* / Q000523:psychology* / Q000628:therapy; D018454:Spouses; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors