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The somatic patient.

T B Purcell1

  • 1Department of Medicine, University of California, Los Angeles.

Emergency Medicine Clinics of North America
|February 1, 1991
PubMed
Summary
This summary is machine-generated.

Patients presenting with unexplained physical symptoms in the Emergency Department often have consciously feigned (malingering, factitious disorders) or unconsciously expressed psychological distress (somatoform disorders). Effective management requires empathy and a thorough search for underlying medical or psychiatric conditions.

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Area of Science:

  • Psychiatry
  • Emergency Medicine
  • Psychosomatic Medicine

Background:

  • Emergency Departments frequently encounter patients with somatic complaints lacking clear physiological explanations.
  • These presentations can stem from conscious fabrication (malingering, factitious disorders) or unconscious psychological stress (somatoform disorders).

Purpose of the Study:

  • To categorize patients with unexplained somatic complaints.
  • To delineate the spectrum of somatoform disorders.
  • To outline management strategies for somatically focused patients.

Main Methods:

  • Classification of patients into conscious (malingering, factitious) and unconscious (somatoform) symptom generation.
  • Detailed description of somatoform disorder subtypes: somatization disorder, psychogenic pain disorder, hypochondriasis, and conversion disorder.

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  • Identification of the "common somatization syndrome" encompassing the first three somatoform disorders.

    • Main Results:

    • Patients with unexplained somatic complaints can be broadly divided into those consciously synthesizing symptoms and those with unconscious psychological expression.
    • Somatoform disorders represent the unconscious expression of psychological stress, with distinct subtypes.
    • The "common somatization syndrome" is a recognized aggregate of somatization disorder, psychogenic pain disorder, and hypochondriasis.

    Conclusions:

    • Management necessitates a compassionate approach combined with diligent medical and psychiatric evaluation.
    • Developing robust patient support systems, including nonmedical resources, is crucial for recovery and integration.