Classification and causes of psychosomatic disorders

It happens that a person's health deteriorates and he goes to the hospital.

The doctor examines him using various methods, but finds no apparent reasonwhich could explain the onset of symptoms.

Further, as a rule, he is sent to doctors of other profiles who also do not find anything.

If you are lucky, one of the doctors may advise the patient to make sure that the symptoms not related to his mental health. And he learns a new word for himself: psychosomatics.

The ICD-10 contains classification of psychosomatic disorderswhich is used by doctors in their practice.

What are psychosomatic disorders?

Psychosomatic disorders - several groups of disorders, the symptoms of which look like a manifestation of a somatic disease, but have a close relationship with the psycho-emotional state of a person.

In psychosomatic diseases, the symptoms may be different, but most often patients complain about the presence of pain in different parts of the body, failures in the functioning of the heart (tachycardia, arrhythmias), and skin rashes.

Word "somatic" means "corporeal"accordingly, somatic diseases are diseases of the body that are accompanied by somatic symptoms.

The term "psychosomatic" came into use at the beginning of the twentieth century, but still the ancient physicians were interested in the relationship between the physical well-being of a person and the psychic.

There is no exact information about the prevalence of psychosomatic disorders, various sources report that the frequency of these diseases varies between 0.5-66%.

Causes

The main reasons for the development of psychosomatic disorders:

Stress. Prolonged hard work requiring high stress tolerance, caring for a sick or dying loved one, prolonged problems in personal life, divorce, domestic violence and many other conditions can cause psychosomatic disorder. Also, the probability of developing these diseases increases if a person has unresolved internal conflicts (some of them may not be realized by the person and be on the subconscious).
Emotional trauma. Each person reacts differently to events occurring with him, and some people even perceive everyday negative situations as traumatic because of the peculiarities of their psyche. Usually such situations as death or illness of a loved one, a pet, a severe episode of violence (both physical, mental and sexual), the moment of receiving information about the presence of a serious illness and the period of its comprehension, getting into an accident.
Unconscious desire of a person to be sick. Some people, for various reasons, perceive the period of illness as something positive, because they receive attention and care from others. Also, a person may form a subconscious desire to be sick, if the disease is able to temporarily free him from anything that gives him discomfort, is a source of stress.
For example, children who do not manage to adapt to kindergarten or school, who are being bullied by their peers, may start to constantly get ARI without any obvious reasons.
Personality features. Sensitive people who have low self-esteem, experience self-doubt, often suffer from psychosomatic disorders.
Suggestion, including self-hypnosis. And the fact of suggestion may not be realized by a person.

Destructive unconscious desire to punish themselves. People who for some reason blame themselves, hate, are able to provoke the development of the disorder. Such people also often have visible auto-aggressiveness: they cut themselves, burn the skin, comb it to the blood, pull out the hair. Autoaggressive tendencies are common in major depressive disorder and other mental illnesses.
The emergence of a strong emotional connection with a person who is sick. This can occur in the process of caring for a loved one, with regular communication with him and is due to the fact that a person can unknowingly copy his symptoms.

In order for the occurrence of a psychosomatic illness to be possible, certain body systems must show a willingness to manifest a functional abnormality.

Kinds

All psychosomatic abnormalities are divided into:

Functional impairment. This group includes disorders in which the body’s performance is impaired, it does not function as it should, but there are no pathological changes in its structure. The most common functional disorders include abnormalities in the heart and vascular system, organs of the gastrointestinal tract, musculoskeletal system, endocrine organs, and the respiratory system.

Conversion deviations. There are changes in the functional and structural nature. Most often, the pathology is manifested in the form of the disappearance of any function: a person may experience paralysis, vomiting, disturbances in the functioning of the organs of hearing and vision, up to deafness and blindness.
Psychosomatosis. This group includes diseases, the occurrence of which is closely related to the psycho-emotional state of a person. These include such diseases as gastric ulcer, duodenal ulcer, atopic dermatitis, vitiligo, hyperthyroidism, type 2 diabetes, rheumatoid arthritis, bronchial asthma, overweight up to obesity of the first to fourth degrees, hypertensive illness.

Symptomatology

Psychosomatic disorders can be accompanied by many different symptoms that can make it difficult for doctors to diagnose, which leads to the formulation of erroneous diagnoses.

Complaints made by patients most often:

Pain. Pain can be localized in different parts of the body: in the abdomen, in the head, behind the sternum, in the joints, muscles.
In this case, doctors can not identify the cause of the pain.
Disorders in the organs of the gastrointestinal tract: vomiting and nausea, especially after eating, heartburn, constipation, diarrhea.
Deviations in the functioning of the heart. Complaints of heart palpitations, irregular heart rhythm, shortness of breath, chest congestion are common.

Loss of function: the disappearance of voice, hearing, vision, various violations of skin sensitivity, paresis, respiratory spasm.
Skin rasheswhich are often accompanied by itching. The nature of the rash may be different: there may be psoriatic rash, small rash, redness, rash, similar to the manifestations of an allergic reaction. During periods of psycho-emotional overload, exacerbations of chronic skin diseases (psoriasis, atopic dermatitis) are observed.
Immune defenseswhich manifests itself in the form of frequent infectious diseases (especially those affecting the respiratory tract and the gastrointestinal tract). Also characterized by prolonged nasal congestion, prolonged cough.
Sleep Disorders: insomnia, multiple awakenings during the night, early awakenings, after which the person cannot fall asleep again, daytime sleepiness.
General weakness, fainting, dizziness. Patients complain of chronic fatigue, difficulty concentrating, fatigue, inability to fully relax, excessive sensitivity to temperature changes.
Weight jumps. Body weight can both significantly decrease and significantly increase in a relatively short time.

Also often there is a loss of interest in sex, impotence, a violation of thermoregulation (throws a person into a fever, in a cold), disruptions in the menstrual cycle, inability to become pregnant, nervous tics, hysterical disorders.

People who suffer from psychosomatic disorders often have hypochondria, so they extremely disturbing to every symptom, they may assume that they have a serious illness, they regularly visit doctors, and they may respond inadequately to the suggestion of a psychotherapist, because they believe that their symptoms are solely of somatic nature.

The situation is complicated if the patient has a pathological fear of getting sick with any disease: carcinophobia, apoplephobia, cardiophophobia, syphilophobia.

Many patients, visiting a psychotherapist, start to take a different look at the symptoms: for example, they notice that exacerbations occur precisely after stressful situations.

Diagnostics

To make the correct diagnosis in the case of psychosomatic disorders - difficult task. Most of the patients, believing that they have a somatic disease, turn to the appropriate doctors, and they send them for examination time after time.

If they have not shown anything of value, the patient is referred to some other doctor, who also finds nothing and sends him to someone else.

In parallel, the patient receives a lot of appointments, drinks drugs, without which you can dosuffers from side effects.

All this can continue for many years: about 25-50% of patients with psychosomatic disorders do not receive the necessary psychotherapeutic treatment due to medical errors and continue to believe that they have a somatic illness.

The diagnosis of psychosomatic disorders includes:

Dialogue with the doctor. The psychotherapist or psychiatrist thoroughly asks the patient about his symptoms and how the disease developed, finds out whether there were severe psycho-emotional upheavals in his life, prolonged stress, internal conflicts, watching the behavior.

Polls The patient is offered to undergo a series of tests that will display his psycho-emotional state and determine the accentuation.
Various specific tests. Tests, in the process of which you need to draw or choose colors (Luscher color test, drawing of a house, a tree). Tests related to drawing, often used when working with children.

Before suspecting a psychosomatic disorder, important to make sure that the symptoms are not associated with somatic diseases.

Treatment

To eliminate psychosomatic symptoms, it is necessary to work out psycho-emotional problems of the patient: resolve internal conflicts, achieve remission in cases of depression, anxiety disorders.

For this, the psychotherapist determines the tactics of treatment, which is based primarily on psychotherapy. Pharmacological methods play a secondary role in the treatment of psychosomatic diseases.

Most often when working with psychosomatic disorders use the following methods:

cognitive-behavioral psychotherapy;
hypnosis;
art therapy;
gestalt therapy;
psychoanalysis;
family psychotherapy;
body-oriented therapy.

Since many of the patient’s psychological problems are in the subconscious areas, the psychotherapist helps him bring them to a conscious level.

After that, they are worked out in accordance with the chosen psychotherapeutic method, they train the patient to feel the connection with the body and control the condition.

The specialist also provides the patient with recommendations on the organization of life and tasks that should be carried out in order to achieve lasting improvement.

Of great importance is the support of relatives and friends. If they show willingness to cooperate and help, it is important for them to come for a consultation with a psychotherapist, discuss the situation with him and listen to recommendations.

If the patient's mental abnormalities are associated with problems in the family, with friends, it is important to work them out in joint sessions with them.

Also, symptomatic treatment is prescribed, which alleviates the pain and discomfort of the patient. They are selected depending on its symptoms.

If necessary, the patient is prescribed drugs in the following groups.:

antidepressants (fluoxetine, imipramine, azafen);
antipsychotics (thioridazine);
mood stabilizers (lithium preparations, risperidone);
benzondiazepines (phenazepam, clonazepam).

Prevention

Basic preventive recommendations:

observe the daily regimen;
try enough time to rest;
night sleep should last at least 6-8 hours;
avoid stressful situations whenever possible;
surround yourself with people you trust and who are distinguished by attentiveness, good nature and understanding;
be in the open air more often;
try to regularly devote time to what is pleasurable;
do sports;
do not hold back emotions and, if necessary, contact a psychologist or psychotherapist;
make sure that the diet was a sufficient number of nutrients.