Somatoform Disorder

Climate medicine: What was once on the radar of just a handful of physicians has exploded into awareness, alarm, and sometimes debate and skepticism. No matter how you look at it, psychiatrists are on the front lines.

The reported severity of the complaints in this patient appears grossly out of proportion given gathered information and clinical observations. What's your diagnosis?

Beyond psychosocial implications of anxiety disorders, an array of physiological effects may ensue.

A patient with lupus presents with rash, arthralgias, and altered mental status. Various symptoms, including stupor and mutism, improve with treatment but higher doses of the drug cause more sedation. How would you proceed?

An update on emerging trends in psychosomatic medicine to help clinicians address mental health stressors in psychiatric and medical settings.

A brief psychosocial tool that offers compassionate, tailored care using existential neuroscience, a new perspective for conducting bedside psychotherapy.

The authors take an in-depth look at the evaluation, diagnosis, and fundamental treatment recommendations, protocols, and guides to therapy for psychogenic nonepileptic seizures.

Although the somatizing disorders cover a vast array of symptomatic domains across many medical specialties, this article addresses the broad topic conceptually.

The need to integrate psychiatric treatment with somatic care puts psychosomatic medicine in a unique position to focus on older patients who would not otherwise seek specialized treatment.

An overview of select topics in clinical psycho-oncology, including assessment and management of delirium and brain lesions, mood and anxiety disorders, medication adverse effects, and existential death anxiety.

A panel of experts at the APA Annual Meeting discussed how changes in DSM-5 may affect clinical practice. Highlights here.

The ethical aim of psychiatry is the relief of suffering and incapacity.

It has moved PFAMC from the back of the book (where it is not a mental disorder) to front and center in the chapter on Somatic Symptom Disorders (where now it will be a mental disorder).

DSM-5 must emphasize that physical symptoms deserve the respect of a thorough work-up before assuming their cause is psychiatric. And people with defined medical illnesses should not be casually mislabeled as also mentally ill just because they are upset about being sick.

The goal of this article is to improve recognition of comorbid psychiatric and movement disorders and to help the reader formulate a management strategy using a multidisciplinary approach.

The primary difference between malingering and factitious disorder is the question of motivation.

Sybil Exposed makes the case that the 1973 book Sybil misrepresents the facts of Shirley Mason’s life, diagnosis, and treatment. It also points to concerns that extend beyond a single case, to the diagnostic concept of multiple personalities. Still, perhaps the books suggests the need for a more systematic look at not just the case of Sybil, but also the diagnosis of dissociative identity disorder (DID).

Understanding pediatric psychopharmacology in the context of medical illness.

The treatment of incest victims is often painful and difficult. With patience, the vast majority of those who have experienced incest can experience considerable improvement and enjoy an enhanced quality of life without succumbing to repeated victimization.

Many psychiatrists, residents, and other mental health professionals believe that psychodynamic therapy lacks empirical support or that other psychotherapies are more effective.

Although acute pain typically resolves on its own with little need for intervention, for some persons pain persists past the point where it is considered an adaptive reaction to injury.

Dramatology approaches human encounters, events, and scenes as dramatic enactments of characters in conflict and crisis.

A new study sheds some light on the pathogenesis of body dysmorphic disorder (BDD). Feusner and colleagues from UCLA, whose study was recently published in Archives of General Psychiatry, used functional MRI to determine whether patients with BDD have abnormal patterns of brain activation when visually processing their own face. The severity of symptoms of this disorder were found to correlate with activity in frontostriatal systems and the visual cortex. http://archpsyc.ama-assn.org/cgi/content/abstract/67/2/197

Unless you have been living on a desert island for the past 2 years, you are well aware that the development of DSM-V is well under way.

Patients who exaggerate, feign, or induce physical illness are a great challenge to their physicians. Trained to trust their patients’ self-reports, even competent and conscientious physicians can fall victim to these deceptions.

Restless legs syndrome (RLS) is a neurosensory disorder first described by Sir Thomas Willis in 1672. As early as the 19th century, Theodor Wittmaack observed the comorbidity of RLS with depression and anxiety. He termed this condition “anxietas tibiarum” and believed it to be a form of hysteria.

Research emerging from the field of emotion science suggests that individuals who have anxiety and mood disorders tend to experience negative affect more frequently and more intensely than do healthy individuals, and they tend to view these experiences as more aversive, representing a common diathesis across anxiety and mood disorders.1-5 Deficits in the ability to regulate emotional experiences, resulting from unsuccessful efforts to avoid or dampen the intensity of uncomfortable emotions, have also been found across the emotional disorders and are a key target for therapeutic change.

The epidemiology and management of psychiatric disability have gained increased attention for a variety of reasons in the past 3 decades. There are issues of empowerment, advocacy, and reduction of stigma. There are also concerns about cost containment as well as reliability, validity, and efficacy of the determination process.

DSM-IV-TR, our current diagnostic classification system of psychiatric disorders, follows the diagnostic paradigm first established by DSM-III in 1980.

Recent research has raised concerns about the adequacy of psychiatric diagnostic evaluations conducted in routine clinical practice, particularly the detection of disorders that are comorbid to the principal diagnosis.