Management of somatic symptom disorder

Henningsen, Peter

doi:10.31887/dcns.2018.20.1/phenningsen

Cited by 113 publications

(83 citation statements)

References 51 publications

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“…Thus, the perception that the main task of the GP is to diagnose, treat and reassure the patient became a barrier to adequately managing PPS. Henningsen stated that good communication with the patients is essential at all stages of PPS and levels of care, including reassurance, anticipation of likely outcomes of diagnostic tests, positive explanations of the functional character of the disorder and motivation of the patient to actively engage in the coping with PPS [ 13 ]. However, our findings showed that PPS is often not communicated in the consultation, and management strategies are not properly addressed, leaving the patients to seek alternatives for symptom relief and management.…”

Section: Discussionmentioning

confidence: 99%

“…In general, patients often found the GP to be inadequately prepared for the consultation, and they perceived the GP to be prejudiced [ 12 ]. In line with this, GPs often experience patients with PPS as burdensome and difficult to treat, and negative attitudes towards these patients are found among GPs [ 13 , 14 ]. GPs struggle with the incongruence between the patients’ persistent symptom presentations and the explanatory models for biomedical disease [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Development of an eHealth programme for self-management of persistent physical symptoms: a qualitative study on user needs in general practice

et al. 2021

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Background Persistent physical symptoms (PPS) are estimated to be present in 17% of patients in general practice. Hence, general practitioners (GPs) play a key role in both the diagnostic assessment and the management of PPS. However, research indicates a need to improve their strategies to support self-help in patients, and eHealth tools may serve as an opportunity. This study aimed to explore patients’ and GPs’ needs related to self-management of PPS. The study was designed to inform the future development of eHealth interventions in this field. Methods This qualitative study was based on 20 semi-structured interviews (6 GPs and 14 patients with PPS). Interviews were audiotaped, transcribed verbatim and analysed through a five-step thematic analysis approach. First, we conducted an inductive analysis to identify and explore emerging subthemes. Second, using a deductive mapping strategy, we categorised the derived subthemes according to the COM-B behaviour change model and its three domains: capability, opportunity and motivation. Results We identified eleven subthemes in the patient interviews and seven subthemes in the GP interviews. Several unmet needs emerged. First, we identified a need to consider PPS early in the illness trajectory by taking a bio-psycho-social approach. Second, both patients and GPs need better skills to manage uncertainty. Third, hope is important for the patients. Fourth, patients need guidance from their GP in how to self-manage their PPS. Conclusions This study provides important insight into key issues and needs related to capability, opportunity and motivation that should be addressed in the design of future eHealth self-management interventions targeting patients with PPS in general practice in order to support and improve care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of an eHealth programme for self-management of persistent physical symptoms: a qualitative study on user needs in general practice

et al. 2021

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“…There have been only few evidences on treatments for SSD that several forms of psychotherapy showed low-to-moderate evidence for e cacy and there has been limited investigations of peripheral interventions. 35 These results of different involvement of brain regions according to organ symptoms suggest the further studies on peripheral interventions for speci c symptom, for example, vestibular rehabilitation for patients with dizziness. This study had several limitations.…”

Section: Discussionmentioning

confidence: 91%

Attenuated, Symptom-specific Alteration of Structural Covariance in Patients With Somatic Symptom Disorder

Park

Jang

Sunwoo

et al. 2021

Preprint

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This study was performed to investigate altered regional gray matter volume (rGMV) and structural covariance related to somatic symptom disorder (SSD) and its phenotypic subtypes. Additionally, this study examined the relationships of structural alteration with cognitive functioning and clinical symptoms. Forty-three unmedicated patients with SSD and thirty normal controls completed psychological questionnaires and neurocognitive tests, as well as brain magnetic resonance imaging. Voxel-based morphometry and structural covariances were compared between groups and between subgroups within the SSD group. Patients with SSD exhibited attenuated structural covariances in the pallidal-cerebellar circuit, as well as regions in the default mode and sensorimotor network, compared to normal controls. The cerebellar rGMVs were negatively correlated with the severity of somatic symptoms. With respect to cognitive functioning, the rGMVs of the right pallidum, left medial orbitofrontal gyrus, and bilateral supramarginal gyrus were correlated with attentional capacity in SSD patients. In subgroup analyses, patients with somatic pain showed denser structural covariances between the bilateral superior temporal pole and left angular gyrus, the left middle temporal pole and left angular gyrus, and the left amygdala and right inferior orbitofrontal gyrus, while patients with headache and dizziness had greater structural covariance between the right inferior temporal gyrus and right cerebellum. The findings revealed the structural alteration involved in SSD; they also suggested that specific brain regions and networks may contribute to different subtypes of SSD.

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“…This was then broken down into Fine and Gross motor, with gross motor being broken down into 2 further leaf categories. The last of the top level groupings was somatic, and this refers to those subjects associated with bodily responses [ 13 ]. Somatic was then broken down into 8 leaf categories.…”

Section: Methodsmentioning

confidence: 99%

Project Rosetta: a childhood social, emotional, and behavioral developmental feature mapping

et al. 2021

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Background A wide array of existing instruments are commonly used to assess childhood behavior and development for the evaluation of social, emotional and behavioral disorders such as Autism Spectrum Disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and anxiety. Many of these instruments either focus on one diagnostic category or encompass a broad set of childhood behaviors. We analyze a wide range of standardized behavioral instruments and identify a comprehensive, structured semantic hierarchical grouping of child behavioral observational features. We use the hierarchy to create Rosetta: a new set of behavioral assessment questions, designed to be minimal yet comprehensive in its coverage of clinically relevant behaviors. We maintain a full mapping from every functional feature in every covered instrument to a corresponding question in Rosetta. Results In all, 209 Rosetta questions are shown to cover all the behavioral concepts targeted in the eight existing standardized instruments. Conclusion The resulting hierarchy can be used to create more concise instruments across various ages and conditions, as well as create more robust overlapping datasets for both clinical and research use.

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Management of somatic symptom disorder

Cited by 113 publications

References 51 publications

Development of an eHealth programme for self-management of persistent physical symptoms: a qualitative study on user needs in general practice

Development of an eHealth programme for self-management of persistent physical symptoms: a qualitative study on user needs in general practice

Attenuated, Symptom-specific Alteration of Structural Covariance in Patients With Somatic Symptom Disorder

Project Rosetta: a childhood social, emotional, and behavioral developmental feature mapping

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