• Title/Summary/Keyword: Somatoform pain disorder

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Somatoform Disorders of Children and Adolescents (소아 및 청소년의 신체형장애)

  • Kim, Seung-Tai P.
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.277-285
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    • 1996
  • Somatoform disorders do occur among children and adolescents. Among the seven disorders under the grouping of somatoform disorders of DSM-IV, three disorders, namely somatization disorder, pain disorder and conversion disorder are seen relatively more often than one can expect in childhood and adolescence. Pain disorders are more prevalent among children before adolescence, whereas conversion disorder and somatoform disorder are seen more often during adolescence and early adulthood. Diagnoses of somatofram disorders should not be made by the process of exclusion, but based on positive findings that positive evidence that normal functioning is possible and that a positive history of psychosocial stress and or intrapsychic conflict exists. Treatment strategy should be mindful of including collaboration with primary care health professionals and family therapy staff in addition to all the basic treatment modalities essential for the treatment of children and adolescents.

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Psychotherapeutic Experience on a Patient with Somatoform Pain Disorder (신체형 동통장애 환자의 정신치료 경험)

  • Kim, Hyun-Woo;Lee, Hyun-Je
    • Korean Journal of Psychosomatic Medicine
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    • v.2 no.1
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    • pp.107-112
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    • 1994
  • The authors tried to look into the process of the individual psychotherapeutic experience of a 18-year-old male diagnosed as somatoform pain disorder or chronic pain syndrome. The patient had showed strong resistance to acceptance of his psychological problems. Some issues such as indications of psychotherapy for chronic pain, changing the mode of the treatment some problems around changing the therapist secondary gain and parents' attitude were discussed considering their relatedness to the outcome. The psychotherapy had lasted about 2 years and the result was estimated as fair.

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One Case Report of GuQiJakTongJung patient with a Retina rupture (망막파열이 동반된 구기작통증(九氣作痛症) 환자 1례(例) 증례보고)

  • Jang, Ha-Jeong;Kim, Ja-Young;Sung, Woo-Yong;Lim, Ho-Jea;Kim, Ju-Won;Seo, Joo-Hee
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.2
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    • pp.199-207
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    • 2006
  • Pain disorder is a category of somatoform disorder that be diagnosed when the pain is starting and getting worse associated with psychological factors. At the recent study, it revealed that stress might be more strong factor in occurring and sustaining the somatoform disorder. In this case, a 42 years old female patient had a chronic pain disorder 3 years ago, suddenly complained of an eyeball pain due to retina rupture induced by severe stress. In the view of oriental medicine, pain disorder belongs to GuQiJakTongJung. So, we diagnosed her state as GuQiJakTongJung and treated her such as herbal medicine, acupuncture and phlebotomy therapy. In result, the chronic pain of the patient was improved, and also general condition was getting better.

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Symptomatic Hallucal Interphalangeal Sesamoid Bones Successfully Treated with Ultrasound-guided Injection - A Case Report -

  • Shin, Hye Young;Park, Soo Young;Kim, Hye Young;Jung, Yoo Sun;An, Sangbum;Kang, Do Hyung
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.173-176
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    • 2013
  • The hallucal interphalangeal sesamoid bone is usually asymptomatic, but it is not uncommon for it to be symptomatic in cases of undue pressure, overuse, or trauma. Even in symptomatic cases, however, patients often suffer for extended periods due to misdiagnosis, resulting in depression and anxiety that can steadily worsen to the extent that symptoms are sometimes mistaken for a somatoform disorder. Dynamic ultrasound-guided evaluations can be an effective means of detecting symptomatic sesamoid bones, and a simple injection of a small dose of local anesthetics mixed with steroids is an easily performed and effective treatment option in cases, for example, of tenosynovitis.

Correlation of Testosterone and Pain Threshold in the Patients with Somatoform Disorder (신체형 장애에서의 Testosterone과 통각 역치의 상관관계)

  • Park, Jae-Hong;Kim, Myung-Jung;Park, Je-Min;Kim, Yong-Ki;Han, Kwi-Won;Park, Seong-Hwa;Yun, Kyung-Il;Chung, Young-In;Kim, Sung-Gon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.22-27
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    • 1998
  • Thirteen female patients of somatization disorder, undifferentiated somatoform disorder and somatoform disorder, NOS, diagnosed by DSM-IV were studied for their pain threshold and serum testosterone and the results were compared with the respective data of 20 control females. The results are as follows : 1) The pain threshold as measured by Variable Weight Pressure Algometer was significantly lower in the patient group(153.8${\pm}$39.5 gm/$0.05mm^2$) as compared to the control group(197.5${\pm}$66.7 gm/$0.05mm^2$)(p<0.05). 2) There was no significant difference of serum testosterone between the patient(0.175${\pm}$0.081 ng/ml) and the control(0.174${\pm}$0.108 ng/ml) groups. 3) A significant positive correlation was noted between the pain threshold and serum testosterone in the patient group(r=0.632, p<0.05, two tailed, Pearson's correlation test), but not in the normal control group(r= -0.405). From these results, it was suggested that the role of testosterone in endogenous pain control system might be more important in somatoform disorders than normals.

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Alexithymia and Pressure Pain Threshold in Patients with Somatoform Disorder who have Pain (동통을 가진 신체형장애 환자에서 감정표현능력과 압통역치)

  • Song, Ji-Young;Kim, Tae-Soo;Oh, Dong-Jae;Yoon, Doh-Joon;Yum, Tae-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.2 no.1
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    • pp.69-79
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    • 1994
  • The authors investigated the relationship between the response to the external stimulation and ability of verbal behavior in the patients with somatoform disorder who have pain. The subjects consisted of 34 patients(male 10, female 24) and 37 normal controls(male 19, female 18). Pressure pain thesholds were measured by algometer and alexithymia was assessed by Toronto Alexithymia Scale(TAS). Somatization Scale of SCL-90R and Parental Bonding Instrument were also used. It was shown that 82.4% of the patients had chronic somatic complaints. The mean values of TAS, degree of somatic symptoms and pressure pain thresholds were significantly higher in the patient group than in the normal controls. 44.1% of the patients was considered alexithymia group and there was no correlation between scores of alexithymia and value of pressure pain thresholds. In conclusion, the patients with somatoform disorder who had pain were dull in pain perception to external physical stimulation. This result suggested that their low perception of pain could be closely related with chronicity of illness. And the Poverty of verbal expression of inner emotion was suggested to be one of the factors affecting somatization and difficulty in psychotherapy.

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Odontogenic Pain and Myofacial Pain: A Case Report (치성동통과 근막동통 : 증례보고)

  • 안은영;홍정표
    • Journal of Oral Medicine and Pain
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    • v.23 no.3
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    • pp.295-299
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    • 1998
  • Pain is a multidimensional experience that involves a complex interaction of sensory,affective and cognitive components. And especially, because of the emotional significance of orofacial pain, it is often a puzzing problem that clinicians are forced with from day to day. This case report describes differential diagnosis and management of dental and myofacial pain affected by psychological factors.

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Deepening the Understanding of Somatization in TMD Pain: A Topical Review

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.47 no.2
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    • pp.78-86
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    • 2022
  • An association between psychological factors and temporomandibular disorders (TMD) has been extensively explored for over 40 years, and a high prevalence of depression and somatization has been consistently reported in patients with TMD. Current evidence suggests that patients' somatic awareness can serve as a primer for TMD incidence and further contribute to the transition to chronic pain. However, the current understanding of somatization from a medical perspective is limited. The best way to address patients with TMD pain who have somatization is also unclear. Therefore, this paper aims to provide an overview of somatization in the context of pain psychology and address its clinical implications in the context of TMD pain.

Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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One Case of Typical Oriental Medical Therapy in Combination with Neurofeedback Therapy on Pain disorder induced by School violence (학교폭력에 노출된 후 발생한 흉통환자 1례(例)에 대한 Neurofeedback과 한방치료 병행 치험례(治驗例))

  • Park, So-Jeong;Byun, Soon-Im;Kim, Sang-Ho;Park, Jong-Hoon;Hwang, Wei-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.2
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    • pp.171-179
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    • 2005
  • School violence is known to cause various emotional, behavioral and social problems. Low self-esteem, lack of self consciousness, sense of alienation, guilty consciousness, somatoform symptoms and low concentration happened to adolescent victims. This patient was suffering for school violence during about a year, then Pain disorder occurred to him. Neurofeedback has been used as a complementary therapeutic relaxation and a increasing self-esteem technique. This patient, is a 13-year- boy, who had been exposed school violence for a year and caused severe and constant pain, was successfully treated by Neurofeedback therapy with oriental medication. This case report is focused on treatment through these methods.

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