[Elements of high-grade iatrogenic risk in care of patients with somatic symptom disorder]

Author analyses the process of care of somatic symptom disorder in the general medical practice with special concern to iatrogenic harms. In his opinion the latency of the patients' first appointment with a psychiatrist or clinical psychologist is caused by multiple factors. Patients do not have knowledge on the basic activities of central nervous system necessary to recognize the pathomechanism. On the other hand, physicians do not know the real clinical picture and the cutpoints of the illness. For laypersons the official nosological definition(s) can be very deceptive and frustrating. While somatic symptom disorder is recently an exclusional diagnosis, there are plenty of unnecessary expensive medical appointments and investigations prior to the first efficient intervention. There is a lack of aimed guidelines and protocols. Consequently both pharmaco- and psychotherapy start late and not in the optimal (individually tailored) way. Considering the real capacities in general practice and also in psychiatry, author points to the most urgent steps which can improve the medical care of patients living with somatic symptom disorders.