Somatic Symptom Disorder. 2016

Stuart L Kurlansik, and Mario S Maffei
Virtua Family Medicine Residency Program, Voorhees, NJ, USA.

With the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., the diagnostic category previously known as somatoform disorders is now called somatic symptom and related disorders. The revisions were intended to increase their relevance in the primary care setting. The main feature of this disorder is a patient's concern with physical symptoms that he or she attributes to a nonpsychiatric disease. Primary care physicians often treat patients who manifest symptoms for which there are no biologic cause, and patients with somatic symptom disorder may be subjected to unnecessary testing and procedures. As a result, appropriate diagnosis is essential. Screening instruments are useful in determining the presence of somatic symptom disorder. It is important for the primary care physician to schedule regular appointments, establish a strong therapeutic alliance, acknowledge and legitimize the patient's symptoms, and limit diagnostic testing or referrals to subspecialists. Proven treatments include cognitive behavior therapy, mindfulness-based therapy, and pharmacotherapy. The use of selective serotonin reuptake inhibitors or tricyclic antidepressants has been effective in alleviating symptoms. Referral to a mental health professional may be necessary when treatment by the primary care physician is ineffective.

UI MeSH Term Description Entries
D008297 Male Males
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071896 Medically Unexplained Symptoms Persistent health symptoms which remain unexplained after a complete medical evaluation. A cluster of symptoms that consistently appear together but without a known cause are referred to as a MEDICALLY UNEXPLAINED SYNDROME (MUS). Somatic Symptoms,Medically Unexplained Symptom,Somatic Symptom,Symptom, Medically Unexplained,Symptom, Somatic,Symptoms, Medically Unexplained,Symptoms, Somatic,Unexplained Symptom, Medically,Unexplained Symptoms, Medically
D000929 Antidepressive Agents, Tricyclic Substances that contain a fused three-ring moiety and are used in the treatment of depression. These drugs block the uptake of norepinephrine and serotonin into axon terminals and may block some subtypes of serotonin, adrenergic, and histamine receptors. However, the mechanism of their antidepressant effects is not clear because the therapeutic effects usually take weeks to develop and may reflect compensatory changes in the central nervous system. Antidepressants, Tricyclic,Tricyclic Antidepressant,Tricyclic Antidepressant Drug,Tricyclic Antidepressive Agent,Tricyclic Antidepressive Agents,Antidepressant Drugs, Tricyclic,Agent, Tricyclic Antidepressive,Agents, Tricyclic Antidepressive,Antidepressant Drug, Tricyclic,Antidepressant, Tricyclic,Antidepressive Agent, Tricyclic,Drug, Tricyclic Antidepressant,Drugs, Tricyclic Antidepressant,Tricyclic Antidepressant Drugs,Tricyclic Antidepressants
D013001 Somatoform Disorders Disorders having the presence of physical symptoms that suggest a general medical condition but that are not fully explained by another medical condition, by the direct effects of a substance, or by another mental disorder. The MEDICALLY UNEXPLAINED SYMPTOMS must cause clinically significant distress or impairment in social, occupational, or other areas of functioning. In contrast to FACTITIOUS DISORDERS and MALINGERING, the physical symptoms are not under voluntary control. (APA, DSM-V) Briquet Syndrome,Pain Disorder,Somatization Disorder,Medically Unexplained Syndrome,Medically Unexplained Syndromes,Disorder, Somatoform,Somatization Disorders,Somatoform Disorder,Syndrome, Briquet,Syndrome, Medically Unexplained,Unexplained Syndrome, Medically
D015928 Cognitive Behavioral Therapy A directive form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. Behavior Therapy, Cognitive,Cognitive Behaviour Therapy,Cognitive Therapy,Psychotherapy, Cognitive,Cognition Therapy,Cognitive Behavior Therapy,Cognitive Psychotherapy,Therapy, Cognition,Therapy, Cognitive,Therapy, Cognitive Behavior,Behavior Therapies, Cognitive,Behavioral Therapies, Cognitive,Behavioral Therapy, Cognitive,Behaviour Therapies, Cognitive,Behaviour Therapy, Cognitive,Cognition Therapies,Cognitive Behavior Therapies,Cognitive Behavioral Therapies,Cognitive Behaviour Therapies,Cognitive Psychotherapies,Cognitive Therapies,Psychotherapies, Cognitive,Therapies, Cognition,Therapies, Cognitive,Therapies, Cognitive Behavior,Therapies, Cognitive Behavioral,Therapies, Cognitive Behaviour,Therapy, Cognitive Behavioral,Therapy, Cognitive Behaviour
D017367 Selective Serotonin Reuptake Inhibitors Compounds that specifically inhibit the reuptake of serotonin in the brain. 5-HT Uptake Inhibitor,5-HT Uptake Inhibitors,5-Hydroxytryptamine Uptake Inhibitor,5-Hydroxytryptamine Uptake Inhibitors,SSRIs,Selective Serotonin Reuptake Inhibitor,Serotonin Reuptake Inhibitor,Serotonin Reuptake Inhibitors,Serotonin Uptake Inhibitor,Serotonin Uptake Inhibitors,Inhibitors, 5-HT Uptake,Inhibitors, 5-Hydroxytryptamine Uptake,Inhibitors, Serotonin Reuptake,Inhibitors, Serotonin Uptake,Reuptake Inhibitors, Serotonin,Uptake Inhibitors, 5-HT,Uptake Inhibitors, 5-Hydroxytryptamine,Uptake Inhibitors, Serotonin,Inhibitor, 5-HT Uptake,Inhibitor, 5-Hydroxytryptamine Uptake,Inhibitor, Serotonin Reuptake,Inhibitor, Serotonin Uptake,Reuptake Inhibitor, Serotonin,Uptake Inhibitor, 5-HT,Uptake Inhibitor, 5-Hydroxytryptamine,Uptake Inhibitor, Serotonin
D017410 Practice Guidelines as Topic Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. Clinical Guidelines as Topic,Best Practices,Best Practice
D039721 Diagnostic and Statistical Manual of Mental Disorders Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii) DSM-IV,DSM-II,DSM-III,DSM-V

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