Some patients complain of various symptoms in the form of pain, irregular heartbeat, and so on.
When examining them no organic change detected.
In this case, we are talking about somatizing, somatovegetative or somatoform disorders.
What it is?
Somatoform, somatovegetative, somatic disorders belong to psychogenic pathologies.
These diseases are understood to be the patient’s condition in which he develops symptoms of various diseases in the absence of real organ damage.
Some patients express simultaneously from 10 to 15 complaintswhile the signs of disease are atypical and polyformal.
If a doctor tries to explain a person the psychogenic nature of his illness, then he meets with aggression and rejection on the part of the patient. Usually somatoform pathologies occur on the background of a depressive state.
Usually, patients undergo a long and thorough examination of all specialists, as a result of which any diseases were excluded. From CP affects about 1% of the population.
The majority of patients are women of 20-45 years, due to the greater mobility of the female psyche.
These disorders are not dangerous for the health and life of the patient, but significantly impair his ability to work and the quality of life, become the causes of conflicts at work and in the family. Such patients take a lot of medical time and create a workload of medical institutions.
Somatoform disorders should be differentiated from mental disorders or conscious simulation of the disease.
In the first case, there are organic brain lesions, in the second, there are no symptoms, the person simply plays a role in achieving some goal. When somatoform disorder patient feels real symptoms diseases.
Classification
The following are described in medicine: types of somatoform dysfunctions:
- Hypochondriacal Disorder.
- Somatoform pain disorder.
- Somatisation disorder.
- Undifferentiated CP.
Hypochondriacal Disorder different obsessive fear of the person that he has an incurable disease. More often, patients “diagnose” cancer, heart ischemia.
In this case, the diagnoses are constantly changing. Patients present with depression, depression, an increased level of anxiety.
Such people with manic persistence looking for confirmation of their fears, are examined at all doctors, spend big money for diagnostics.
The mood of a person also changes: from that he prepares for death, then calms down and hopes to live some more.
Somatoform pain disorder manifested pain of a different nature. They differ in intensity and localization. However, other autonomic disorders are absent.
A variation of this CP - chronic somatoform pain disorder. The patient experiences constant pain, excruciating and localized in one place, usually in the heart or head.
Somatisation disorder similar to hypochondria, but the patient has hope that his disease will eventually be “found” and cured.
He categorically denies the psychogenic origin of the symptoms, conflicts with the doctor, falls into depression.
Somatoform vegetative dysfunction expressed in vegetative signs: dizziness, fainting, palpitations, lack of air, heart pain. Doctors usually diagnose “vegetative vascular dystonia” or IRR.
Patients believe that they have a somatic disease, but there is no fear and conviction in an incurable disease, as is the case with hypochondria. In the end, the patient is resigned to the fact that he has somatoform dysfunction of the ANS and learns to live with it.
With undifferentiated CP the patient has various complaints, but the clinical picture does not fall under any of the above diseases.
The reasons
Doctors allocate three groups of causes of CP:
- genetic predisposition;
- psychological reasons;
- organic factors.
Heredity - This is a genetic predisposition to depression, hypochondria, hysteria.
In such people, the nervous system is characterized by instability, mobility, and increased reactivity.
They are shy, uncommunicative, quickly tired. In patients low pain threshold revealed: where the other person feels tension, such a patient will have a pain attack.
AT group of psychological reasons includes external factors that affect the psycho-emotional state of a person:
- children's psychological trauma;
- family conflicts;
- professional failures;
- traumatic situations (death of a loved one, loss of job, divorce).
Organic factors are the consequences of somatic disorders. For example, complications after pregnancy, severe infection, trauma. Organic lesions are already cured, and psychological pain persists.
Symptomatology
Distinctive features of CP are:
- Multiple manifestations of various diseases that are not confirmed during the examination.
- The duration of the pathology is at least 2 years.
- Chronic and recurrent course of the disease.
- During emotional stress, new symptoms occur.
- The acute period lasts about six months, the period of remission - from 9 months to a year.
- Exacerbation usually occurs when the weather changes, exacerbates the psychological situation.
- The patient denies any attempt to convince him of the absence of a true pathology.
Symptoms of CP are different in localization and intensity. They can be permanent or regularly changed. Often the patient himself can not determine exactly what hurts him.
Most often, patients complain of the following manifestations:
- pain behind the sternum, stomach, head;
- dizziness, sudden fainting;
- panic attacks;
- lack of air;
- palpitations.
These symptoms are accompanied by bad mood, fatigue, loss of interest in life, anxiety, fear, dissatisfaction with their lives.
Diagnostics
Diagnosis of CP can be supplied based on the following factors:
- The presence of various inaccurate symptoms for 1.5-2 years in the absence of organic lesions.
- Distrust of the patient to all doctors who have undergone examination, unwillingness to follow their recommendations.
- The categorical rejection of the psychogenic nature of pathology.
- A history of psychotraumatic situation.
TO somatoform diseases include the following ailments: cardioneurosis, irritable bowel syndrome, pulmonary hyperventilation syndrome.
Pathology should be differentiated from other serious diseases: multiple sclerosis, lupus erythematosus, hyperthyroidism. These somatic diseases begin with atypical manifestations.
In this case, blood tests for hormones, rheumatoid factor, etc., are prescribed. deviations in the composition of the blood is not observed.
Also, SR should not be confused with true mental illnesses, such as schizophrenia. This requires the consultation of a psychiatrist, the passage of special tests and research.
Diseases of the psyche are usually distinguished by constancy of clinical manifestations and their smaller number
Treatment
Therapy of somatoform dysfunctions includes a combination of drug and psychotherapeutic agents.
Drug therapy
Drug treatment is used to relieve existing symptoms.
The following groups of drugs are prescribed:
- Antidepressants tricyclic series (Amitriptyline, Clomipramine). They help reduce anxiety, normalize mood.
- Neuroleptics (Aminosine, Iglonil). Reduce the transmission of nerve impulses to the brain, which leads to a decrease in tension and the elimination of autonomic symptoms.
- Sleeping pills prescribed for insomnia and severe anxiety. They try to use herbal preparations (Novopassit, Tenoten, Melaxen, Sonmil), because synthetic hypnotics (Fenazepam) are addictive and have many side effects.
Psychotherapy
Most patients with somatoform disorders do not require inpatient treatment, and may undergo outpatient therapy.
Only 30% are placed in specialized psychiatric clinics: neurosis clinics, sanatorium departments of psycho-dispensaries.
The choice of method of psychocorrection depends on the severity of the symptoms and the patient's desire to recover. The most effective techniques:
- Dynamic Therapy It involves 3-4 sessions per week. The patient during the session says everything that comes to his head. The goal of treatment is the patient's awareness of subconscious experiences.
- Cognitive behavioral therapy. The doctor is trying to change the thinking and behavior of the patient. A patient with the help of a doctor discovers destructive thoughts that negatively affect his life. Then the patient develops new behavioral skills, sets positive attitudes.
- Relaxation sessions. The patient is taught relaxation techniques that relieve nervous and muscular tension. As a result, the patient has a normal heartbeat, breathing is restored, pain symptoms disappear. A person becomes more efficient and stress-resistant.
Good result give group classes to improve communication skills, art therapy.
How to fight: the advice of psychologists
For successful treatment of CP, it is important normalization of the day regimen, nutrition and physical activity.
Healthy sleep and moderate exercise contribute to the restoration of psychological balance. It is necessary to lie down and get up at the same time. Walking before bed has a beneficial effect on sleep.
A person must learn not to save problems and experiences in himself, but to talk about them, share with relatives.
Deal in sudden panic and fear attacks simple recommendations will help:
- Do not be afraid and try to relax with the help of breathing techniques: short breaths and slow exhalations.
- Maximum relax the muscles of the body and try to distract from disturbing thoughts, think about something pleasant.
- After the attack, remember all the details of the incident: what preceded the deterioration of health, what were the thoughts, where the attack occurred. This will help to avoid relapse next time.
Prognosis and prevention
Despite the absence of organic lesions, CP leads to dire consequences.
The main complications are a disability, a breakdown in family and friendships.
In addition, the patient may develop true depression requiring long-term treatment in the hospital.
Treatment of CP is long, gradually the drugs cancel and leave only psychotherapeutic sessions. Subject to all recommendations, the prognosis is favorable.
However, getting rid of the disease impossible without the desire of the patient himself and the support of loved ones. He must be aware of the psychogenic origin of the dysfunction and not hamper the doctors.
The prevention of SWs consists in creating a favorable psychological situation at home and at work, giving up bad habits, playing sports, and normalizing work and rest schedules. Emotional and physical overvoltages and conflicts should be avoided.
Somatoform disorders are much more common than they appear to be. a serious problem for doctors and the patient himself.
Modern rhythm of life, constant stress contribute to the increase in the number of such pathologies. You can get rid of the problem only after the realization of its psychogenic nature.
Somatoform disorder of the nervous system: symptoms, how to determine? Find out from this video:
