scholarly journals How do physicians manage functional neurological and somatic symptom disorders in the emergency department? a vignette methodology

2021 ◽  
Author(s):  
Ozge Kilic ◽  
Hale Yapici-Eser ◽  
Isil Necef ◽  
Umut Altunoz ◽  
Ozgur Oztop-Cakmak ◽  
...  
2020 ◽  
Vol 83 (2) ◽  
pp. 174-181
Author(s):  
Stefanie Caroline Linden

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.


Author(s):  
Kelli Jane K. Harding ◽  
Brian A. Fallon

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.


2019 ◽  
Vol 121 ◽  
pp. 107
Author(s):  
Christina van der Feltz-Cornelis ◽  
Iman Elfeddali ◽  
Dilana Ozgul ◽  
Jonna van Eck van der Sluijs

2017 ◽  
Vol 19 (2) ◽  
Author(s):  
Nasuh Malas ◽  
Roberto Ortiz-Aguayo ◽  
Lisa Giles ◽  
Patricia Ibeziako

Sign in / Sign up

Export Citation Format

Share Document