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SANIMA Klinik am Mayenberg
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Somatoform Func­tional Disorders.

Due to the variety of somatoform complaints and the often years-long path of suffering those affected endure through fruitless medical investigations, it is difficult to give figures on the prevalence of the entire group of somatoform conditions. Overall, in primary care within our healthcare system, we estimate that 15–30 % of all consultations in general practice are attributable to somatoform complaints.

Inpatient Treatment · Private Insurance · Government Allowance · Self-Pay

Medically reviewed by
Vivien Müller-Prasse, Specialist in Psychiatry and Psychotherapy
Last updated
Reading time
approx. 7 minutes
Mandala for somatoform disorders: dark core with sharp thorns
The physical expression of psychological distress
Primary Care Consultations15–30%

of all consultations in general practice are attributable to somatoform complaints.

Clinical Picture

When the body speaks.

By somatoform complaints we mean physical symptoms or discomfort for which no organic cause sufficiently explaining the complaints — nor a corresponding physical illness — can be found. When a physician cannot identify a pathological finding, many people feel reassured, but others remain unsettled and press for further medical investigation. This can set in motion a vicious cycle of self-observation, anxious perception of physical discomfort, and catastrophising beliefs that there must ultimately be a physical cause.

Common somatoform complaints include headaches and facial pain, abdominal pain, feelings of fullness, flatulence, palpitations, chest burning, respiratory difficulties, bladder problems, back pain, sensory disturbances (tingling sensations), and much more. Somatoform symptoms can affect the entire body, frequently shifting between body regions, but in every case causing years of impairment and considerable distress. We speak of a somatoform disorder when somatoform complaints have been present for at least two years, yet the person affected, despite repeated medical investigation and negative test results — i.e. despite the absence of organopathological findings — continues to insist that a physical cause must exist and that further diagnostic work must be carried out. People with a somatoform disorder often remain focused for years on the belief that it must be 'something physical.' They visit physicians frequently, change doctors, feel misunderstood, and are in despair. Their entire lives narrow around the respective complaints; avoidance and protective behaviour set in, often leading to problems at work or within the family.

Subtypes

Subtypes and distinctions.

We currently distinguish several subtypes of somatoform disorders. There is not only the so-called somatisation disorder, in which a variety of frequently changing somatoform symptoms and years of inconclusive investigations are reported, but also somatoform autonomic dysfunction, which over a long period relates to a single organ system (heart, respiration, digestion, or bladder), as well as hypochondriacal disorder, in which those affected observe their own body and discomfort excessively, suspect a specific illness, and seek medical clarification. Persistent pain disorders for which no sufficiently explanatory organic correlate can be found are also classified as somatoform disorders.

In addition, there are the so-called psychosomatic conditions in the narrower sense. These are diagnosed physical conditions for which psychological factors represent at least an important influencing variable (asthma, neurodermatitis, tinnitus, hypertension, ulcerative colitis, gastric ulcer, etc.).

Treatment

Treatment at Sanima Klinik.

The treatment of somatoform disorders and the co-treatment of psychosomatic conditions initially focuses on broadening the existing illness model ('there must be something physical') to include a psychosomatic illness model, in which connections are established between stressors (e.g. conflicts), coping mechanisms (conflict avoidance, fear of arguments), psychological experience (suppressed anger), and the symptoms (tinnitus, tension, back pain). Psychoeducation, bibliotherapy, and the keeping of a symptom diary provide initial relief and sensitise patients to the interplay between psychological and physical experience. Relaxation techniques reduce inner tension, mindfulness exercises focus on the non-judgmental acceptance of the current state, biofeedback opens up perspectives for self-regulation of physical functions, dance and movement therapy makes the unity of body and mind tangible, and physical exercise therapy promotes physical activity, confidence in one's own body, and strengthens overall resilience. In this stabilisation phase, those affected experience for the first time in a long while that they are not at the mercy of their physical complaints, but that their symptoms can be influenced by psychological factors (for better or worse), and that personal responsibility and self-efficacy exist for contributing to physical and psychological wellbeing. Particularly important here is developing a realistic concept of health that does not exclude possible physical discomfort and does not lead to protective and avoidance behaviour, social withdrawal, or secondary illness gain (e.g. entitlement to consideration from others).

In in-depth individual psychotherapy work, the goal is ultimately to understand somatoform symptoms not only against the background of external stressors (e.g. conflicts), but also in the context of one's own relational and behavioural patterns (e.g. fear of conflict), inner themes (e.g. self-worth), and their biographical references. This allows engagement with one's own formative experiences to begin, accompanied by a multimodal therapy programme consisting of the above-mentioned approaches but also art therapy, music therapy, psychoeducational and psychodynamic group therapies.

The goal of treating somatoform disorders is to learn how to cope with physical symptoms, to perceive them as signals from the psyche, to understand them, and to learn how to influence them.

Häufige Fragen

Answers to frequently asked questions about somatoform disorders.

Patients, relatives, and referring physicians ask us recurring questions. Here you will find the most important answers summarised.

01.What are somatoform disorders?

Physical symptoms or discomfort — such as pain, palpitations, gastrointestinal or respiratory complaints — for which no organic cause sufficiently explaining the symptoms is found despite repeated medical investigation. If the complaints persist for at least two years, we speak of a somatoform disorder.

02.Are the complaints 'imagined'?

No. The complaints are real and cause considerable distress. They simply have no organopathological cause — which is why treatment is needed that addresses body and mind together.

03.Who covers the cost of treatment?

Admission is open to privately insured patients, those entitled to government allowance (Beihilfe), and self-pay patients. Some statutory health insurers (e.g. Techniker Krankenkasse and DAK) stipulate in their statutes that, under certain conditions, they may cover the costs of treatment at a purely private clinic up to the level of comparable rates at a hospital approved under Section 108 SGB V. We are happy to advise you during the initial telephone consultation.

04.How do I arrange an admission interview?

By telephone on +49 7083 748-0 (Mon–Fri 8:00–16:30) or via the Call-Back Service on the contact page. Our admissions office will respond within 24 hours with a proposed appointment for a detailed, no-obligation telephone consultation.

Quellen

Fachliche Grundlage der Inhalte.

  1. [1]S3 Guideline: Functional Somatic Symptoms AWMF Guideline Registry (ed.). register.awmf.org — current guidelines
  2. [2]ICD-10-GM — Chapter V, F45 (Somatoform Disorders) Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM). bfarm.de — ICD-10-GM
  3. [3]Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) Specialist information. dgppn.de
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Patients of some statutory health insurance providers (e.g. Techniker Krankenkasse and DAK) may in certain cases be able to obtain partial cost reimbursement from their insurer.

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