68-year-old Uncle Zheng (pseudonym) due to long-term stomach discomfort, repeated hiccups, visited four hospitals, the test results are normal, but Uncle Zheng's condition did not improve, but there is a trend of aggravation. Recently, under the strong persuasion of his family, Uncle Zheng came to the Department of Physical Disease psychiatry (male) of the Second People's Hospital of Hunan Province (Hunan Brain Hospital).
Outpatient Dr. Liu Yadi asked for a detailed medical history, combined with a psychological scale, and finally diagnosed with somatic form disorder.
It's just that the stomach is uncomfortable, the others are very good, how can it be a mental problem?
According to Uncle Zheng's recollection, about five years ago, because of eating fish, he was stuck in the throat by the fish thorn, and then removed in the hospital, and then he has been worried that the fish thorn will pierce the stomach, feel the stomach discomfort, burp, and do gastroscopy many times, there is no problem. In addition, according to the family, Uncle Zheng is more introverted, sensitive, and not good at actively expressing his inner feelings.
Somatic form disorder is a neurosis characterized by persistent fear or belief in the preponderance of various somatic symptoms. Patients seek repeated medical attention to these symptoms, and various negative medical examinations and doctors' explanations cannot dispel their doubts. Even if there is sometimes a physical disorder, it does not explain the nature and extent of the symptoms complained of, or the concept of pain and superiority.
Dr. Liu Yadi further explained that patients with somatic form disorder, because of their own personal characteristics or tendencies, such as excessive sensitivity and suspicious personality, and no educational guidance in life, are prone to fear emotions when facing unexpected situations, and because they do not know how to deal with this emotion, they instinctively fear and escape, and then suppress this emotion. As life continues, fear slowly accumulates, and when the body's container reaches saturation, this emotion manifests itself physically, forming a body form disorder.
In terms of treatment, somatoform disorders should be treated with a combination of psychotherapy and pharmacotherapy. Psychotherapy gives patients explanations, guidance, and dredging, so that they can understand the knowledge of disease symptoms, alleviate emotional symptoms, and enhance confidence in treatment. Drug therapy has high health requirements for patients and is sensitive to somatic reactions, so drugs with small adverse reactions should be selected and treated in small doses. People with obvious anxiety and depressive symptoms can be given an appropriate amount of anti-anxiety drugs or antidepressants, often with an anxiolytic drug (alprazolam, lorazepam, clonazepam, etc.) in small doses.
Liu Yadi said that when patients have corresponding symptoms, family members should apply a gentle and friendly attitude, patiently listen to patients, family members can not ignore the patient's physical symptoms, but also can not deny the patient's discomfort to the body, should assist patients to complete self-care, encourage patients to express their emotions and pressure, encourage patients to discuss the pressure of life.
Patients themselves should also cultivate their own way of relieving emotions, such as sports, entertainment, etc., increase communication with the outside world and family, friends should communicate more, learn to express unpleasant emotions, when self-regulation is more difficult, it is recommended to seek professional help, timely medical treatment!
Contributed by: Department of Physical Disease Psychiatry (male) Yang Qi
Editor: Shi Rong
Image: From the Internet, intrusion and deletion