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Somatoform pain disorder: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Pain pain is manifested by pain in one or more anatomical areas, sufficiently pronounced to cause distress or impairment of social, professional or other functioning. It is believed that psychological factors play a dominant role in the onset of the disease, its severity, exacerbations, the maintenance of symptoms, but pain is not caused intentionally and is not imitated. Some patients may recall the original cause that caused acute pain. The diagnosis is based on anamnestic information. Treatment begins with the creation of persistent, supportive relationship between the doctor and the patient; psychotherapy can also help.
The proportion of people whose chronic pain is due to mental factors is unknown. However, pain is rarely defined as "everything in the patient's head"; The apperception of pain involves sensory and emotional components.
[Symptoms of somatoform pain disorder
Pain caused by mental factors is common in mood disorders and anxiety disorders, but with pain disorder is the main complaint. Pain can be localized in any part of the body, but more often in the back, head, abdomen and chest. The pain can be acute or chronic (more than 6 months). The underlying diseases or trauma can explain the pain, but not its severity, duration or degree of disability caused by it.
The diagnosis is based on anamnestic information after the elimination of a physical illness that could adequately explain the pain and its severity, duration and degree of disability. The isolation of mental or social stressors can help in explaining the disorder.
Treatment of somatoform pain disorder
A thorough medical examination followed by weighty assurances may be sufficient. Sometimes there is an effective indication of a relationship with obvious mental and social stressors. However, in many patients the problems become chronic and very poorly treatable. Patients are reluctant to associate their problems with psychosocial stressors and usually refuse psychotherapy. They can visit many doctors expressing a desire to receive treatment, and are at risk of developing dependence on opioids and benzodiazepines. Careful regular reassessments conducted by an attentive doctor who remains wary of the possibility of developing a new significant physical illness and at the same time protects the patient from unnecessary and potentially expensive or dangerous examinations or procedures is the best way to obtain long-term relief.