scholarly journals Triggers and Clinical Presentations of Functional Neurological Disorders: Lessons from World War 1

2020 ◽  
Vol 83 (2) ◽  
pp. 174-181
Author(s):  
Stefanie Caroline Linden
Keyword(s):  
Life Events ◽  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Symptom Clusters ◽  
Physical Factors ◽  
World War ◽  
Combat Experience ◽  
Female Patients ◽  
Symptom Profiles ◽  
Somatic Symptom Disorders

Introduction: The psychological contribution to functional neurological and somatic symptom disorders is a major topic in current medical debate. Objective: For an understanding of the processes leading to functional somatic symptoms, it is paramount to explore their relationship with stress and life events and to elucidate the contribution of cultural factors. Methods: A total of 937 case records of civilian and military patients with functional somatic disorders treated in London during World War 1 were analysed. Group differences in symptom profiles and contemporaneous diagnoses were tested with χ2 tests. Results: Paralyses and speech disturbances were significantly more common in soldiers (43.3 and 17.2% of cases) than in civilian male (28.1 and 6.5%) and female patients (32.4 and 7.5%), whereas female patients had the highest rates of pain (48.6%) and somatic symptoms (67%). Triggers were identified in around two-thirds of cases and included accidents, physical illness, and work stress, in addition to the combat experience of the soldier patients. The nature of the trigger influenced symptom expression, with acute (combat and noncombat) events being particularly prone to trigger loss of motor function. Symptom profiles showed a great deal of multi-morbidity and overlap, although some symptom clusters were more (motor and speech disturbance) or less common (pain and loss of energy) in soldiers than civilians. Triggering life events in civilians were similar to those reported by patients with somatic symptom disorders today, with an important role of physical factors. Patterns of multi-morbidity and symptom clusters also resembled those of modern cohorts. Conclusions: Analysis of historical records, illness trajectories, and treatments can enhance the understanding of the presentation, mechanisms, and course of functional neurological and related disorders and their consistency over time.

Somatic Symptom and Related Disorders

2014 ◽  
Author(s):  
Kelli Jane K. Harding ◽  
Brian A. Fallon
Keyword(s):  
Somatic Symptom ◽  
Body Dysmorphic Disorder ◽  
Primary Care Patient ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Physical Symptoms ◽  
Care Patient ◽  
Factitious Disorder ◽  
The Difference ◽  
Somatic Symptom Disorders

This chapter discusses the somatic symptom disorders, which are a heterogeneous group unified by physical symptoms or concerns that are associated with prominent distress or impairment. Somatic symptom disorders are estimated to account for 1 in 10 primary care patient visits. The relative prominence of somatic symptoms is essential to the difference between illness anxiety disorder, which is an example of the obsessional/cognitive subtype (not prominent) and somatic symptom disorder,, in which the somatic symptoms are prominent. Patients with body dysmorphic disorder, also an Obsessional/Cognitive subtype, are preoccupied with a perceived defect in physical appearance. Patients with conversion disorder (functional neurological symptom disorder) (dissociative sub-type) present with neurological symptoms that cannot be fully explained physiologically. Patients with factitious disorder consciously simulate illness for psychological purposes rather than practical gain.

Somatic symptom and related disorders

2015 ◽  
pp. 226-232
Author(s):  
Martin Brüne
Keyword(s):  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Somatic Complaints ◽  
Conscious Awareness ◽  
Factitious Disorder ◽  
Somatic Symptom Disorder ◽  
Illness Anxiety Disorder ◽  
Somatic Illness ◽  
Illness Anxiety ◽  
Somatic Symptom Disorders

Somatic symptom disorders are characterized by the presentation of somatic complaints (somatization), often, but not necessarily, in the absence of a medical explanation of these sensations. The level of concern is generally disproportionate in relation to the severity of the somatic illness. Behaviourally, somatic symptom disorder entails signals that call for help and attention from others. Evolutionary considerations of why people present with somatic symptoms in the absence of a medical cause suggest that this behaviour could reflect a strategy to manipulate others in order to evoke care. Signals that aim at eliciting care from others are more persuasive if the ‘real’ intention is hidden from conscious awareness. Thus, self-deception may be involved in the presentation of somatic symptoms. Within the spectrum of somatic symptom and related disorders, the degree of self-deception may vary from high, as in illness anxiety disorder, to relatively low, as in factitious disorder.

Retreating From Life: The Boy Whose Body Experienced His Pain

2018 ◽  
Vol 17 (6) ◽  
pp. 406-424
Author(s):  
Anna Harwood ◽  
Amit Shalev ◽  
Sharon Ben-Shaul ◽  
Rachel Meir ◽  
Ela Kiansky ◽  
...  
Keyword(s):  
Somatic Symptom ◽  
Treatment Protocol ◽  
Treatment Strategies ◽  
Somatic Symptoms ◽  
Psychiatric Ward ◽  
Current Case ◽  
Individual Personality ◽  
Somatic Disorders ◽  
Somatic Symptom Disorders

The expression of psychological distress through somatic symptoms is most prevalent among children. Somatic symptom disorders represent a difficult category of disorders to treat and they are often misdiagnosed due to their physical symptomology and dismissed due to their malingering stigma. The current case report follows the treatment of David, a 10-year-old Caucasian male, admitted into the pediatric psychiatric ward of a general hospital, uncommunicative, showing little signs of responsiveness, and dependent on nursing staff for basic needs. Following a complex treatment protocol which integrated key elements of psychodynamic and cognitive-behavior (CBT) treatment recommendations for somatic disorders, David was discharged after 6 months as an inpatient. This in-depth case study provides a synthesis of the varied research on somatic symptom disorders and an acute understanding of how to combine the understanding of complex family dynamics and individual personality structure with empirically reinforced treatment strategies.

Development of the Concepts for Providing Close Air Support

2020 ◽  
Vol 26 (1) ◽  
pp. 64-74
Author(s):  
Hristov Manush
Keyword(s):  
United States ◽  
Air Force ◽  
The United States ◽  
Second World War ◽  
The State ◽  
World War ◽  
Present Stage ◽  
Combat Experience ◽  
Second World

AbstractThe main objective of the study is to trace the perceptions of the task of an aviation component to provide direct aviation support to both ground and naval forces. Part of the study is devoted to tracing the combat experience gained during the assignment by the Bulgarian Air Force in the final combat operations against the Wehrmacht during the Second World War 1944-1945. The state of the conceptions at the present stage regarding the accomplishment of the task in conducting defensive and offensive battles and operations is also considered. Emphasis is also placed on the development of the perceptions of the task in the armies of the United States and Russia.

Muscular strain as risk factor of somatic symptom of mix anxiety and depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S406-S406
Author(s):  
M. Bhadar ◽  
S. Asghar ◽  
Z. Mukhtar
Keyword(s):  
Poor Prognosis ◽  
Somatic Symptom ◽  
Somatic Symptoms ◽  
The Body ◽  
Anxiety And Depression ◽  
Body Parts ◽  
Muscular Tension ◽  
Increased Risk ◽  
Severity Of Depression ◽  
Competing Interest

IntroductionSomatic symptoms in depression are not uncommon. There is increased sicidality, poor prognosis, and increased risk of relapse. Neurological and l muscloskeletal symptoms can be explained on basis of increased muscular tension in the body.MethodsAn internet search was made using key words muscular tension, SSRIs depression, anxiety, somatic symptoms.ResultsNinety-eight percent patients reported at least one of somatic symptoms. Forty-five percent reported six somatic symptom. GIT symptoms in 67% patients. Fatigue in 78% % of patients. Weakness in body parts 45% and headache in 43% to 65%. Chest pain more common in male. Patient over 40 showed pain in limbs or joints. Number of symptoms was directly related to severity of depression.DiscussionIncreased muscular tension is one component of mix anxiety and depression. Main nerves and their branches pass in between muscular bellies. When there is increased muscular tone, it puts extra compression on major nerves and their branches. This will cause dysesthesia in body parts. Stretching of muscles produce pain due to hypoxia. This produces headache, strain neck and backache pain in chest. Fatigue is result of over consumption of energy due to hypertonia. One of their side effect is of SSRIs is muscular hypertonia which will not be very helpful for these symptoms. Drugs like tricyclics, SNRI can have better results when used alone, gabapentine, pregabline tinazidine used as adjunct can alleviate symptoms. Non-pharmacological treatment includes massage, relaxation technique, and warm water therapy.ConclusionSomatic symptoms of mix anxiety and depression should be important consideration in its treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Unexplained Physical Complaints

1989 ◽  
Vol 154 (S4) ◽  
pp. 24-27 ◽  
Author(s):  
Javier I. Escobar ◽  
Glorisa Canino
Keyword(s):  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Symptoms Of Depression ◽  
Physical Complaints

‘Hypochondria’, ‘hypochondriasis’, and ‘somatisation’ are terms long used to characterise individuals who display unrelenting somatic symptoms that cannot be medically explained. A psychiatric aetiology for such phenomena is often assumed on the basis of potential psychological gain, the presence of ‘stressors’, the co-existence of unexplained somatic symptom and symptoms of depression or anxiety, or merely the absence of a medical explanation.

The epidemiology of psychiatrist-ascertained depression and DSM-III depressive disorders Results from the Eastern Baltimore Mental Health Survey Clinical

1992 ◽  
Vol 22 (3) ◽  
pp. 629-655 ◽  
Author(s):  
A. J. Romanoski ◽  
M. F. Folstein ◽  
G. Nestadt ◽  
R. Chahal ◽  
A. Merchant ◽  
...  
Keyword(s):  
Major Depression ◽  
Life Events ◽  
Depressive Disorders ◽  
Multiple Logistic Regression ◽  
Adverse Life Events ◽  
Future Studies ◽  
Symptom Profiles ◽  
Examination Method ◽  
Treatment Of Depression ◽  
History Of

SynopsisPsychiatrists used a semi-structured Standardized Psychiatric Examination method to examine 810 adults drawn from a probability sample of eastern Baltimore residents in 1981. Of the population, 5·9% was found to be significantly depressed. DSM-III major depression (MD) had a prevalence of 1·1% and ‘non-major depression’ (nMD), our collective term for the other depressive disorder categories in DSM-III, had a prevalence of 3·4%. The two types of depression differed by sex ratio, age-specific prevalence, symptom severity, symptom profiles, and family history of suicide. Analyses using a multiple logistic regression model discerned that both types of depression were influenced by adverse life events, and that nMD was influenced strongly by gender, marital status, and lack of employment outside the home. Neither type of depression was influenced by income, education, or race. This study validates the concept of major depression as a clinical entity. Future studies of the aetiology, mechanism, and treatment of depression should distinguish between these two types of depression.

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