Results matching “medically unexplained” from Research in Psychosomatic Medicine

  Somatic symptoms of medically unknown origin are highly prevalent in the community and clinical settings; not only the primary care setting but also the secondary care setting(1-3), and are clinically important(4).  Functional somatic syndrome (FSS) refers to several related syndromes that are characterized more by symptoms, suffering, and disability than by disease-specific, demonstrable abnormalities of structure or function(6). 

   FSSs include various diseases in many medical specialties such as irritable bowel syndrome, functional dyspepsia, fibromyalgia syndrome, and chronic fatigue syndrome.


  FSSs are expected to share a common underlying pathophysiology (6).  Among the regulating systems in human body, we have been focusing on autonomic nervous system (ANS) and its relationship to stress.  The following two aspects should be considered in the pathophysiology of FSS: a) dysregulation of the stress response in ANS and b) psychological factors that modulate the expression of symptoms.  These two aspects of pathophysiology interact with one another.

References

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1. Kellner R.: Functional somatic symptoms and hypochondriasis. A survey of empirical studies. Arch Gen Psychiatry, 42, 821-33, 1985
2. Peveler R, Kilkenny L, Kinmonth AL.: Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion. J Psychosom Res, 42, 245-52, 1997
3. Reid S, Wessely S, Crayford T, Hotopf M.: Frequent attenders with medically unexplained symptoms: service use and costs in secondary care. Br J Psychiatry, 180, 248 -53, 200
4. Wessely S, Nimnuan C, Sharpe M.: Functional somatic syndromes: one or many? Lancet, 354, 936 -9, 1999
5. Henningsen, P., Zipfel, S., Herzog, W.: Management of functional somatic syndromes. Lancet, 369, 946-55, 2007.
6. Barsky AJ, Borus JF.: Functional somatic syndromes. Ann Intern Med, 130, 910 -21, 1999
7. Lacey JI, Bateman DE, VanLehn R.: Autonomic response specificity. An experimental study. Psychosom Med, 15, 8 -21, 1953
8. Wenger MA, Clemens TL, Coleman MA, Cullen TD, Engel BT.: Autonomic response specificity. Psyshosom Med, 23, 185-93, 1961
9. Fink P, Toft T, Hansen MS, Ornbol E, Olesen F.: Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosom Med, 69(1), 30-9, 2007
10. Henningsen, P., Zimmermann, T., Sattel, H.: Medically unexplained physical symptoms, anxiety, and depression: a meta-analytic review. Psychosom Med, 65, 528-33, 2003
11. Kanbara, K., Fukunaga, M., Mutsuura, H. et al.: An exploratory study of subgrouping of patients with functional somatic syndrome based on the psychophysiological stress response: its relationship with moods and subjective variables. Psychosom Med, 69, 158-65, 2007
12. Kanbara, K., Mitani, Y., Fukunaga, M. et al.: Paradoxical results of psychophysiological stress profile in functional somatic syndrome: correlation between subjective tension score and objective stress response. Appl Psychophysiol Biofeedback, 29(4), 255-268, 2004
13. Nimnuan, C., Rabe-Hesketh, S., Wessely, S., Hotopf, M.: How many functional somatic syndromes?.J Psychosom Res, 51, 549-57, 2001
14. Robbins, J.M., Kirmayer, L.J., Hemami, S.: Latent variable models of functional somatic distress. J Nerv Ment Dis, Oct;185(10), 606-15, 1997
15. Kanbara, K., Mitani, Y., Fukunaga, M. et al.: Characteristics of psychophysiological stress responses in patients with psychosomatic disorders. Japanese Journal of Psychosomatic Medicine, 45, 685-695, 2005
16. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation, 93, 1043-65,1996.

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