Case Report: Somatic Symptoms Veiling Gender Dysphoria in an Adolescent

Background: Somatic symptom disorder is common in children and adolescents; usually, it is an expression of a mental health problem or other conditions that lead to psychosocial impairment and suffering. Among these, in pubertal age, gender dysphoria should be considered.Case Presentation: We present the case of a 15-year-old girl admitted to the hospital because of a 2-month history of scattered arthralgia and myalgia, headache, and fatigue, with repeated visits to the emergency room. The physical exam was unremarkable, except for step walking and pain. Repeated diagnostic tests were normal, and consecutive psychological interviews disclosed intense suffering due to a gender incongruence. Referral to the hospital gender service was offered and refused by the parents.Conclusions: In pubertal age, gender dysphoria may be expressed through somatoform symptoms. Diagnosis is challenging to accept for the parents even in the presence of adequate multi-disciplinary hospital services.

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Loneliness and Mental Health: The Mediating Effect of Perceived Social Support

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182211963 ◽

2021 ◽

Vol 18 (22) ◽

pp. 11963

Author(s):

Elody Hutten ◽

Ellen M. M. Jongen ◽

Anique E. C. C. Vos ◽

Anja J. H. C. van den Hout ◽

Jacques J. D. M. van Lankveld

Keyword(s):

Mental Health ◽

Social Support ◽

Social Connectedness ◽

Somatic Symptom ◽

Somatic Symptoms ◽

Mediating Effect ◽

Somatic Symptom Disorder ◽

Physical And Mental Health ◽

Anxiety Depression ◽

The Relationship

Social connectedness is a fundamental human need. The Evolutionary Theory of Loneliness (ETL) predicts that a lack of social connectedness has long-term mental and physical health consequences. Social support is a potential mechanism through which loneliness influences health. The present cross-sectional study examined the relationship between loneliness and mental health, and the mediating effects of social support in a Dutch adult sample (N = 187, age 20 to 70). The health variables included in the study are anxiety, depression, somatic symptoms as measured by the SCL-90, and the DSM-5 diagnosis somatic symptom disorder. The results indicated that social support partially mediated the relationship between loneliness and anxiety, depression, and somatic symptoms. These results indicate that social support partially explains the relationship between loneliness and physical and mental health issues. The relationship between loneliness and being diagnosed with somatic symptom disorder was not mediated by social support. This suggests that the mechanisms through which loneliness relates to either somatic symptoms or somatic symptom disorder are different.

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Attachment and Crying in Patients with Medically Unexplained Somatic Symptoms

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-019-00180-4 ◽

2019 ◽

Vol 1 (12) ◽

pp. 1065-1072

Author(s):

R. Jansman ◽

M. M. E. Riem ◽

S. Broekhuizen-Dijksman ◽

C. Veth ◽

E. Beijer ◽

...

Keyword(s):

Symptom Severity ◽

Somatic Symptom ◽

Somatic Symptoms ◽

Negative Attitude ◽

Attachment Anxiety ◽

Negative Attitudes ◽

Medically Unexplained ◽

History Of ◽

And Behavior ◽

Medically Unexplained Somatic Symptoms

AbstractMentalization deficits and disturbances in emotional functioning may contribute to somatization in patients with medically unexplained somatic symptoms (MUSS). The present study aimed to increase understanding the psychological factors that contribute to somatization by examining associations between attachment, crying attitudes and behavior, and somatic symptoms in these patients. Attachment security was measured with the Experiences in Close Relationships Questionnaire in sixty-eight outpatients diagnosed with MUSS. Somatic symptom severity was measured with the RAND-36, crying frequency, and attitudes with the Adult Crying Inventory. Patients were asked to evaluate photographs of crying individuals in order to assess the perception of crying and empathic responses to crying. Attachment anxiety was significantly related to somatic symptom severity and negative attitudes toward crying. In addition, somatic symptom severity was related to a more negative attitude toward crying and less awareness of the interpersonal impact of crying on others. The association between attachment anxiety and somatic symptoms was, however, not mediated by crying or negative attitude toward crying. Neither were there significant associations between attachment, somatic symptoms, and empathic responses to crying. Altered attitudes to crying may stem from a history of insecure attachment experiences and may reflect maladaptive emotion strategies in MUSS patients.

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Mental health in COVID-19 survivors from a general hospital: association with sociodemographic, clinical, and inflammatory variables

10.21203/rs.3.rs-146200/v1 ◽

2021 ◽

Author(s):

Jeff Huarcaya-Victoria ◽

Jesica Barreto ◽

Lucia Aire ◽

Angela Podestá ◽

Mónica Caqui ◽

...

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Psychiatric Treatment ◽

Significant Proportion ◽

Somatic Symptoms ◽

Cross Sectional ◽

Telephone Interviews ◽

Distress Symptoms ◽

Mental Symptoms ◽

History Of

Abstract Background: The current COVID-19 (coronavirus disease 2019) pandemic constitutes a significant problem for the world's public health and generates mental health problems.Objective: To describe the characteristics of mental health in survivors of COVID-19 and the main sociodemographic, clinical, and immune factors related.Method: A Cross-sectional and correlational study was conducted on 318 patients (196 women, mean age 54.4 ± 15.1 years) surviving COVID-19 from one hospital in Peru in which sociodemographic, clinical, and immune characteristics were explored. Through telephone interviews, an evaluation of the presence of depressive, anxious, somatic, and distress symptoms was carried out using standardized scales. Adjusted prevalence ratios (PRa) were estimated.Results: A significant proportion of the patients have depressive (30.3%), anxious (29.9%), somatic (33.7%), and distress (28.7%) symptoms. In the regression analysis, the variables associated with a higher frequency of clinically relevant mental symptoms were female sex (depression: aPR = 2.29; anxiety: PRa = 2.71; somatic symptoms: PRa = 2.04; distress: PRa = 2.11), proceeding outside the capital (depression: PRa = 1.61; anxiety: PRa = 1.53), the self-perception of a greater severity of the infection (depression: PRa = 5.53; anxiety: PRa = 2.29; distress: PRa = 14.78), the presence of persistent COVID-19 symptoms (depression: PRa = 8.55; anxiety: PRa = 11.38; somatic symptoms: PRa = 5.46; distress: PRa = 20.55), a history of psychiatric treatment (depression: PRa = 2.29; somatic symptoms: PRa = 2.90 ; distress: PRa = 3.80), the history of a family member infected by COVID-19 (anxiety: PRa = 4.71; somatic symptoms: PRa = 1.99), and a neutrophil-lymphocyte index greater than 6.5 (depression: PRa = 1.67; anxiety: PRa = 1.82).Conclusion: COVID-19 survivors show a high prevalence of negative mental symptoms. Some useful variables have been found when identifying vulnerable patients requiring psychiatric care.

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Can Coronavirus Disease-19 Lead to Temporomandibular Joint Disease?

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5003 ◽

2020 ◽

Vol 8 (T1) ◽

pp. 142-143

Author(s):

Dinesh Rokaya ◽

Sittichai Koontongkaew

Keyword(s):

Mental Health ◽

Temporomandibular Disorder ◽

Psychological Problems ◽

Joint Disease ◽

Background Information ◽

Drinking Alcohol ◽

Psychosocial Impairment ◽

The People ◽

History Of ◽

Masticatory Apparatus

BACKGROUND: The coronavirus disease (COVID-19) has become pandemic spreading globally. The outbreak of COVID-19 has led to psychological problems and compromised the mental health of the people. Temporomandibular disorder (TMD) shows the pain and dysfunction of the masticatory apparatus. History of trauma, stress, psychosocial impairment, drinking alcohol, and catastrophizing are related to the TMD. AIM: We aimed to present some background information, in which COVID-19 may be correlated with TMD. METHODS: The outbreak of COVID-19 has led to psychological problems and compromised the mental health of the people. RESULTS: The outbreak of COVID-19 has led to psychological problems and compromised the mental health of the people, not those only who suffered from coronavirus but also to those in self-isolation, social-distancing, and quarantined. TMD shows the pain and dysfunction of the masticatory apparatus, and one of the major causes of TMD is stress and psychosocial impairment apart from drinking alcohol and history of trauma. Hence, TMD may be correlated with COVID-19. The consequences of anxiety, depression, and stress in people from the outbreak of COVID-19 may lead to TMD. CONCLUSION: Hence, COVID-19 may be correlated with TMD as one of the major causes of TMD is stress and psychosocial impairment.

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Somatic Symptoms As Measured By Ssi-26 (somatic Symptom Inventory) Correlate With Social And Physical Functioning (sf36) In Depressed Patients. The Relative Contribution Of Anhedonia

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1518 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S420-S421

Author(s):

A.L. Pérez Morenilla ◽

A. Salazar ◽

I. Failde ◽

J.A. Mico

Keyword(s):

Mental Health ◽

Social Functioning ◽

Physical Functioning ◽

Somatic Symptom ◽

Bodily Pain ◽

Somatic Symptoms ◽

Somatization Disorder ◽

Depressed Patients ◽

Relative Contribution ◽

Competing Interest

According to the DSM5, Somatic Symptom Disorder (SSD) is characterized by somatic symptoms that are either very distressing or result in significant disruption of functioning. These criteria are significantly different compared with previous editions of DSM. For example, the DSM-IV diagnosis of somatization disorder required a specific number of complaints from among four symptom groups, however the SSD criteria no longer have such a requirement. Nevertheless somatic symptoms must be significantly distressing or disruptive to daily life. Very few studies have focussed on the influence of suffering anhedonia on the perception of somatic symptoms and how this impact on Health Related Quality of Life (HRQoL), particularly physical functioning. We studied the relative impact of somatic symptoms on the social and physical functioning in depressed patients. Moreover we have explored the influence of anhedonia as measured by the Snaith-Hamilton Anhedonia Pleasure Scale (SHAPS). We analysed the correlations between the scores of the 8 dimensions of the SF-36, the SSI-26 and the SHAPS questionnaires. The results show a significant correlation between SSI-26 score and physical functioning (r = –0.565; P < 0.001), role physical (r = –0.551; P < 0.001), bodily pain (r = –0.659; P < 0.001), general health (r = –0.534; P < 0.001), vitality (r = –0.481; P = 0.001), social functioning (r = –0.302; P = 0.044) and mental health (r = –0.461; P = 0.001). Additionally, SHAPS score correlates with vitality (r = –0.371; P = 0.012), social functioning (r = –0.574; P < 0.001) and mental health (r = –0.445; P = 0.002). The results demonstrated that both somatic symptoms and level of anhedonia negatively correlate with HRQoL, suggesting a potential relationship between level of anhedonia and some somatic symptoms. This could impact on the diagnosis and treatment of depressed patients with somatic symptoms and anhedonia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Somatic symptom and related disorders

Textbook of Evolutionary Psychiatry and Psychosomatic Medicine ◽

10.1093/med:psych/9780198717942.003.0014 ◽

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.

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Difficult differentiation of a somatic symptom disorder from anterior cutaneous nerve entrapment syndrome (ACNES): a case report

BMC Psychiatry ◽

10.1186/s12888-019-2390-2 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Narifumi Yokoyama ◽

Ryousuke Shiraki ◽

Takashi Watanabe ◽

Makiko Shiinoki ◽

Michihiro Nin ◽

...

Keyword(s):

Somatic Symptom ◽

Trigger Point ◽

Physical Symptoms ◽

Nerve Entrapment ◽

Cutaneous Nerve ◽

Somatic Symptom Disorder ◽

Case Presentation ◽

Entrapment Syndrome ◽

Medically Unexplained ◽

Nerve Entrapment Syndrome

Abstract Background Somatization is regarded as psychological or emotional distress in the form of physical symptoms that are otherwise medically unexplained. Case presentation We report a case of a patient with a somatic symptom disorder (SSD) and depression who was later diagnosed with anterior cutaneous nerve entrapment syndrome (ACNES) when Carnett’s test was positive and block anesthesia using trigger point injections dramatically improved the symptom of abdominal pain. Conclusion We concluded that the differentiation of SSDs, such as psychogenic pain, from ACNES is very difficult. Psychiatrists should be aware of this syndrome.

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Complexity Assessed by the INTERMED in Patients With Somatic Symptom Disorder Visiting a Specialized Outpatient Mental Health Care Setting: A Cross-sectional Study

Psychosomatics ◽

10.1016/j.psym.2017.02.008 ◽

2017 ◽

Vol 58 (4) ◽

pp. 427-436 ◽

Cited By ~ 11

Author(s):

Jonna F. van Eck van der Sluijs ◽

Lars de Vroege ◽

Annick S. van Manen ◽

Cees A.Th Rijnders ◽

Christina M. van der Feltz-Cornelis

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Somatic Symptom ◽

Care Setting ◽

Cross Sectional Study ◽

Somatic Symptom Disorder ◽

Sectional Study ◽

Cross Sectional ◽

Outpatient Mental Health

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Concern for Covid-19 cough, fever and impact on mental health. What about risk of Somatic Symptom Disorder?

Journal of Mental Health ◽

10.1080/09638237.2021.1875418 ◽

2021 ◽

pp. 1-5

Author(s):

C. Willis ◽

T. Chalder

Keyword(s):

Mental Health ◽

Somatic Symptom ◽

Somatic Symptom Disorder

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Présent et avenir des troubles somatoformes

European Psychiatry ◽

10.1016/j.eurpsy.2015.09.115 ◽

2015 ◽

Vol 30 (S2) ◽

pp. S40-S41

Author(s):

C. Lemogne

Keyword(s):

Somatic Symptom ◽

Somatic Symptoms ◽

Prise En Charge ◽

Somatic Symptom Disorder ◽

Dsm V ◽

Dsm Iv ◽

Troubles Somatoformes

Dans le DSM-IV, les « troubles somatoformes » étaient définis négativement par la présence de symptômes somatiques « médicalement inexpliqués ». Cette appellation a disparu du DSM-V au profit des somatic symptoms and related disorders. Les troubles somatisation, douloureux, somatoforme indifférencié et l’hypocondrie, lorsqu’elle est associée à des symptômes somatiques, sont regroupés sous l’appellation unique de somatic symptom disorder. Ce trouble est désormais défini positivement par la présence de pensées, émotions ou comportements « excessifs ou inappropriés », à l’origine d’un retentissement fonctionnel ou d’une souffrance subjective et accompagnant des symptômes somatiques ayant, ou non, une cause somatique identifiée. Les raisons de ce changement sont le recouvrement diagnostique des anciennes catégories, leur non-utilisation par les somaticiens, le risque de stigmatisation et le caractère intenable d’une conception dualiste des rapports corps-esprit. La notion de symptômes « médicalement inexpliqués » demeure néanmoins centrale dans la conversion, renommée « trouble neurologique fonctionnel ». Plusieurs études d’imagerie cérébrales fonctionnelles portant sur un petit nombre de patients présentant un déficit moteur unilatéral ont tenté d’élucider la physiopathologie de ce trouble. Certains résultats semblent reproductibles : hyperactivation et hypo-activation controlatérales respectivement des cortex cingulaire antérieur et moteur primaire. Ces résultats ont servi de rationnel à l’utilisation thérapeutique de la stimulation magnétique transcrânienne. L’hypocondrie sans symptômes somatiques devient dans le DSM-V « l’anxiété pour la santé », caractérisée par la crainte excessive d’avoir ou de développer une maladie. La prise en charge est souvent difficile et peut renforcer les symptômes si elle est inappropriée. Plusieurs études ont montré l’efficacité des thérapies cognitives et comportementales, basées sur la restructuration cognitive et l’extinction des comportements d’évitement, ainsi que des thérapies basées sur la pleine conscience. Compte tenu du lien fréquent entre pensées intrusives et souvenirs douloureux, la valeur ajoutée d’une thérapie des schémas est vraisemblable.

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