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Chapter 7 - Functional Somatic Symptoms

Published online by Cambridge University Press:  04 January 2024

By
Constanze Hausteiner-Wiehle  and
Peter Henningsen
Edited by
Rachel Thomasson ,
Elspeth Guthrie  and
Allan House
Rachel Thomasson
Affiliation:
Manchester Centre for Clinical Neurosciences
Elspeth Guthrie
Affiliation:
Leeds Institute of Health Sciences
Allan House
Affiliation:
Leeds Institute of Health Sciences
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Summary

In the absence of defined disease, but also on top of it, functional somatic symptoms indicate subjective distress. They have multidimensional, individual origins and their course is heterogeneous. We do not understand their exact psychophysiological pathways yet, but we know that stressors, attention/expectation and the way we handle them matter a lot. This applies especially to consultation-liaison psychiatry, where patients rarely have one single and simple problem, and there are frequent mismatches between the subjective symptom burden and objective findings.

Management of functional somatic symptoms should be interdisciplinary, mixing diagnostic and therapeutic, physical and psychological techniques. Treatment is based on empathy, psychoeducation, activation and the development of a bio-psycho-social explanatory model. Symptom relief and co-morbid illness can require medication, but passive interventions should only be temporary, with weighted risks and benefits. More severe cases need a multimodal approach or psychotherapy, carefully addressing the embodied self with all its experiences, attitudes and resources.

Keywords

symptomsfunctionalpersistentmedically unexplainedsomatoformbodily distressbody–mind
Type
Chapter
Information
Seminars in Consultation-Liaison Psychiatry , pp. 97 - 116
Publisher: Cambridge University Press
Print publication year: 2024

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References

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