Synonyms
Pain disorder, psychalgia English term: pain disorder, somatoform pain disorderA persistent somatoform pain disorder (ASD) is a disorder characterized by persistent severe pain without somatic (physical) cause, so that psychological causes are regarded as triggers (emotional conflicts, psychosocial problems). A variety of causes can cause a persistent somatoform pain disorder. Accordingly, it is less individual factors than an interplay of various factors that lead to this pain disorder.
Such factors are neurophysiological (e.g. differences in pain perception and pain transmission), learning theoretical (e.g. learning by model – learning by observation), personality specific (e.g.
processing of stress) and social (e.g. culture). The first step is to exclude physiological causes of pain by means of a medical (neurological = specialist in neurology) examination. The pain leads to an enormous amount of suffering, so that more personal or medical help is needed.
Following the guidelines for psychotherapeutic medicine and psychosomatic medicine (2002), an exact anamnesis (previous history) should also be taken, since factors such as physical abuse occur more often in the biography of the person affected. Patients with a psychological cause of their pain do not localize it precisely, describe the pain more emotively and less with sensory terms (e.g. “burning“, “pulling”, etc.). According to the ICD guidelines, the pain symptomatology must last longer than six months.
The psychological triggers of ASD (persistent somatoform pain disorder) must be distinguished from those psychological stress factors that only emerged during the course of ASD (persistent somatoform pain disorder). Pain conditions that occurred in the course of a depressive disorder or schizophrenia should not be taken into account. Furthermore, no signs of simulation should be present.
The first step in the treatment of persistent somatoform pain disorder is first of all to prevent unnecessary measures to eliminate the pain that is not physically caused (e.g. by invasive, i.e. invasive procedures that penetrate the body). Psychotherapy is the treatment of choice for persistent somatoform pain disorder.
Here, a behavioral therapy approach will focus particularly on strategies for pain management, changing subjective models of disease and altering the function of pain. Body-related elements of psychotherapy aim to change body perception and mindfulness. Psychodynamic elements, on the other hand, focus on early childhood traumatization and the mechanism of somatization, i.e. mental conflicts manifest themselves in physical symptoms.
In addition to psychotherapy, antidepressive medication (amitriptyline) should be administered. Tranquilizers (tranquilizers) or neuroleptics (drugs for the treatment of psychoses, e.g. schizophrenia) should not be administered.
