Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty
Abstract
:1. Introduction
1.1. Gaps, Restrictiveness, and Deficiencies in the Healthcare Systems
1.2. Consequences of Diagnostic Errors
1.3. Guidelines
2. Materials and Methods
3. Results
3.1. Case Presentations and Discussion
3.1.1. Case Presentations
3.1.2. Discussion of Case Presentations
3.2. Defining Relevant Terms
3.2.1. Mental Health
3.2.2. Mental Illness, Mental Disorder
3.2.3. Psychosomatic Disorders
3.2.4. Somatopsychic Disorders
3.2.5. Multisystem Disorders
3.2.6. Medical Uncertainty
3.2.7. Diagnostic Terms
Relevant Mental Disorders Recognized by the American Psychiatric Association Diagnostic and Statistical Manual
Somatic Symptom Disorders
Somatoform Disorders and Medically Unexplained Symptoms
Functional Neurological Symptom Disorder
Illness Anxiety Disorder
Factitious Disorders, Factitious Disorder Imposed on Another
3.2.8. Functional Disorders
3.2.9. Psychogenic Disorders
3.2.10. Compensation Neurosis
3.2.11. Psychogenic Seizures
3.2.12. Psychogenic Pain
3.2.13. Delusional Parasitosis
3.2.14. Subjective vs. Objective Complaints and Symptoms
3.2.15. Non-Specific and Vague Symptoms
3.2.16. Bodily Distress Disorder, Bodily Distress Syndrome
4. Discussion
4.1. Significant Issues
4.2. Cause, Effect vs. Interactive Relationship
4.3. Multisystem vs. Psychosomatic Disorders
4.4. Excessive Concern Regarding Symptoms
4.5. Can Fatigue Be Psychogenic?
4.6. Ethical Concerns
4.7. Adequacy of Assessment
“There is no more difficult art to acquire than the art of observation.”
“If you listen long enough, the patient will give you the diagnosis.”
“Medicine is learned by the bedside and not in the classroom. Let not your conceptions of disease come from the words heard in the lecture room or read from the book. See and then reason and compare and control. But see first.”
“To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.”
“The greater the ignorance, the greater the dogmatism.”
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
PACE | Patient graded activity and cognitive behavior therapy |
IDSA | Infectious Disease Society of America |
MUS | Medically Unexplained Symptoms |
APA | American Psychiatric Association |
DSM-5 | Diagnostic and Statistical Manual of Mental Disorders, 5th Edition |
ICD | International Classification of Diseases |
ALPIM | Anxiety-laxity-pain-immune-mood |
DSM-IV-TR | Diagnostic and Statistical Manual, Fourth Edition, Text Revision |
ME/CFS | Myalgic encephalomyelitis/chronic fatigue syndrome |
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Term | DSM-5 Diagnosis | ICD-10 Diagnosis | ICD-11 Diagnosis |
---|---|---|---|
All in your head | No | No | No |
Somatic symptom disorder | Yes | Yes | No |
Somatoform disorder | No | No | No |
Medically unexplained symptoms | No | No | No |
Functional neurological symptom disorder | Yes | Yes | No |
Conversion disorder | No | Yes | No |
Illness anxiety disorder | Yes | No | Yes |
Factitious disorder imposed upon another (Munchausen’s by proxy) | Yes | Yes | Yes |
Functional disorders | No | Yes | No |
Psychogenic disorders | No | Yes | No |
Compensation neurosis | No | No | No |
Psychogenic seizures | No | Yes | Yes |
Psychogenic pain | No | Yes | No |
Psychogenic fatigue | No | No | No |
Delusional parasitosis | No | Yes | Yes |
Subjective vs. objective | No | No | No |
Non-specific or vague symptoms | No | No | No |
Bodily distress disorder | No | No | Yes |
Bodily distress syndrome | No | No | No |
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Bransfield, R.C.; Friedman, K.J. Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty. Healthcare 2019, 7, 114. https://doi.org/10.3390/healthcare7040114
Bransfield RC, Friedman KJ. Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty. Healthcare. 2019; 7(4):114. https://doi.org/10.3390/healthcare7040114
Chicago/Turabian StyleBransfield, Robert C., and Kenneth J. Friedman. 2019. "Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty" Healthcare 7, no. 4: 114. https://doi.org/10.3390/healthcare7040114