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[Definition of somatoform disorders: somatic symptoms or mental symptoms?]
Jean-Arthur Micoulaud-Franchi1, Cédric Lemogne2, Clélia Quilès3
1Service d'explorations fonctionnelles du système nerveux, clinique du sommeil, CHU de Bordeaux, Bordeaux, France. USR CNRS 3413 SANPSY, CHU Pellegrin, université de Bordeaux, France.
Abstract:
Definition of somatoform disorders: somatic symptoms or mental symptoms? Somatoform disorders, which used to be considered as mental disorders, are frequent, especially in the context of non-psychiatric medical consultations. The absence of an identifiable organic cause for these disorders often leads clinicians to underestimates their harmful consequences or even challenge their validity as disease. However, they are real disorders that may have a major impact on the quality of life and functional outcomes of the subject and whose mechanisms can be targeted by therapeutic interventions. Although psychiatric classifications support a unitary approach (i.e. the "somatic symptom disorder and related disorders" of the American Psychiatric Association's DSM - Diagnostic and Statistical Manual of Mental Disorders - or the "bodily distress disorder" of the World Health Organization), each non-psychiatric specialty has described some "functional somatic syndromes", which are deemed more specific and less severe regarding psychiatric severity, and thus more often remain in the field of non-psychiatric specialties. In this article, we have presented the initial stage of any medical approach of suffering: a clarification of the issues involved in the delimitation of the normal and the pathological, and the organization of the different categories between them. These nosographic aspects are the condition of a rigorous approach in medicine, and of a relationship with the patient that is useful to understand and relieve his or her genuine suffering.
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