Written by: Sarah Sallam
Design by: Eman Yehia
Nowadays, it’s a widely recognized that most diseases are influenced to a certain extent by mindset and emotions. Regardless, the term psychosomatic disorder still refers to symptoms with no identifiable physical cause triggered purely by mental factors. They vary widely in terms of presentation and cause.
Stress and anxiety are part and parcel of everyday life, but their high and excessive levels can result in somatic pain, high blood pressure or gastrointestinal disturbances. Other common causes of psychosomatic disorders include difficulty recognizing emotions, depression, abuse or even a chaotic and turbulent lifestyle. These are all quite clearly psychological and mental factors but they often also present somatically. In fact, the patients are usually completely convinced that they are suffering from a physical systemic disorder.
Patients may have minor complaints like fatigue, indigestion or back pain. Symptoms could also be more serious like migraines, paralysis or asthma and difficulty breathing. Upon physical examination and testing, no causes are found, leaving doctors stumped.
It is vital to exclude all possible causes, including rare or tropical ones, before ruling symptoms as psychosomatic. A study found that up to 15% of patients with a psychosomatic diagnosis are misdiagnosed.[3]
According to a EURORDIS survey, psychological misdiagnosis extends diagnosing time up to 14 times more than misdiagnosing with a physical disorder. This emphasizes that it’s not a simple diagnosis to make and the physician should be certain of it.
Extensive testing also helps convince patients. It helps overcome the instinctive denial, anger and feeling of helplessness. Good doctor-patient communication and thoroughly explaining the situation is vital to avoid defensiveness. Patients are then finally referred to a psychologist for treatment.
Overall, psychosomatic disorders have existed for centuries. Doctors should stop resorting to them as a diagnosis immediately upon negative initial testing. Most importantly, they should also carefully consider the best way to appeal to their patient when giving the diagnosis for best results and prompt initiation of therapy.
Resources:
[5] It’s All In Your Head, by Suzanne O’Sullivan
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