Psychosomatic illness Part 3

This is the final of a 3-part series.

Causes

The exact cause is not known, there may be a genetic link. Somatoform disorders represent the major form of psychosomatic illness. Somatoform disorders may be a coping strategy related to a previous life experience or trauma such as abuse or loss. It may be a learned behaviour, or the result of a personality characteristic. Research also indicates possible comorbidities with other mental health disorders, such as mood disorders, anxiety disorders, personality disorders, eating disorders, and psychotic disorders. Irrespective of causes, the symptoms are real to the person experiencing them, not imagined or made up.

A reaction to a particular emotional or psychological experience, past or present, may act as a trigger to the disorder.

Risk factors

It can be difficult to identify specific risk factors. If a family member has had a somatoform disorder in the past, a person may also be at risk. Other risk factors include:

• Past sexual, emotional or physical abuse
• A major childhood illness
• Poor or reduced ability to show or express emotions

How is psychosomatic illness treated?

Diagnosis and subsequent treatment of somatoform disorders, can not only be challenging and can create stress and frustration for patients. Believing or feeling that there's no known explanation for their symptoms and getting nowhere can then lead to further increased stress and a vicious cycle ensues as they then become even more worried about their health. Once actual physical causes of symptoms have been eliminated, the focus of further treatment is based on a continuing, trusting, supportive relationship between patient and GP or lead health professional, in the mutual knowledge that there is in fact something to treat.  Once a treatment pathway has been agreed, close monitoring of progress through regularly scheduled follow up appointments is important for treatment success.

Psychiatric treatment of somatoform disorders

The GP may refer a patient to a psychiatrist or qualified mental health professional for help in managing their disorder. Psychotherapy and particularly “talking therapies” such as CBT (cognitive-behavioural therapy), may prove effective in dealing with those underlying psychological factors that are causing the physical symptoms and having a positive effect on both. Stress management techniques may also be part of the therapy. Learning to identify, anticipate and manage stress in a healthy way can help those patients where stress brought on by certain triggers is a particular issue.

If a mental disorder, such as depression, anxiety etc. is identified, then treatment with suitable medications may also be recommended and initiated as part of the overall programme.

Symptomatic treatment of somatoform disorders

Talking therapies such as CBT, whilst proven effective in a wide range of mental health management strategies, are not necessarily beneficial for everyone, so for some, symptoms may continue. In such cases, treatment will then be centred on providing symptomatic relief and helping people live normal lives.

Medication

As stated above, comorbid psychiatric disorders should be treated with the appropriate intervention. Medications can help to provide relief from symptoms, such as headache, fatigue, pain, and digestive problems etc. However, any medication should be used sparingly and always for an identified cause and in many cases may not be needed.

Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended