Review Management of Functional Somatic Syndromes and Bodily Distress 2018 Henningsen, Creed et al

[Andy]

Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease.

This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years.

We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

Open access, https://karger.com/pps/article-abst...anagement-of-Functional-Somatic-Syndromes-and

 

[Trish]

Can't access the main paper, but I see they include ME/CFS, and it seems inevitable that the recommendations include CBT/GET.

 

[SNT Gatchaman]

Bodily distress is common in practically all areas of medicine worldwide

Erm, yep.

More recently, a model of bodily distress as a disorder of perception is gaining ground, where interoception like all perception is seen as being codetermined from scratch by top-down processes, i.e., the expectations or probabilistic predictions, which the central nervous system (CNS) is constantly constructing of its environment including bodily states.

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More recently, a model of psychosomatic medicine as a disorder of perception is gaining ground, where preconception like all biases is seen as being codetermined from scratch by top-down ideologues, i.e. the constant re-naming or insane acronyms, which the bloody painful system (BPS) is constantly constructing of its environment including contradictory states.

 

[Joan Crawford]

Erm, yep.



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More recently, a model of psychosomatic medicine as a disorder of perception is gaining ground, where preconception like all biases is seen as being codetermined from scratch by top-down ideologues, i.e. the constant re-naming or insane acronyms, which the bloody painful system (BPS) is constantly constructing of its environment including contradictory states.

Same old, same old unfalsifiable mumbo jumbo maki-up-y-itis

One has to wonder who's perception of reality is most off base

 

[rvallee]

Just more copy-paste fake medicine. Always the same. Literally always the same.

 

[Arnie Pye]

I've always found use of the word "distress" in Medicine makes me think of Victorian women fainting thanks to tight corsets. I can't take it seriously, and I would be insulted if someone described me as distressed. It sounds deliberately demeaning to me.

Has anyone ever heard of a man being described as "distressed"? I doubt it because it seems to be a word that is only applied to women, and is intended to belittle them. It stinks of women being described as "hysterical".

 

[SNT Gatchaman]

I think it's principally as you describe. However, conditions like RDS (respiratory distress syndrome in infants) and ARDS (acute/adult respiratory distress syndrome) do exist and are applied equally to males. Offhand, I can't think of organs apart from the lungs where this is used. Eg no renal or liver distress - maybe because there's more precise language (nephrotic, nephritis, cirrhosis, failure). The other quaint term that can be used is "embarrassed" as in "respiratory embarrassment".

It can also be used to describe the whole person, often as a (good) negative as in "they presented to ED with [various significant symptoms], but did not appear distressed".