Somatoform Disorders

Treatments

Placebo Acupuncture             

Treatment Summary: In this study Kerr, Shaw, Conboy, Kelly, Jacobson & Kaptchuk (2011) looked at the use of placebo acupuncture in place of traditional acupuncture on patients suffering from unidentified or medically unexplained physical symptoms; somatoform disorders. This form of treatment is compared to other placebo treatments such as sugar pills, and even to the traditional Eastern healing method of Rieki. 

• Reference: Kerr, C.E., Shaw, J.R., Conroy, L.A., Kelly, J.M., Jacobson, E., & Kaptchuk, T.J. (2011). Placebo acupuncture as a form of ritual touch healing: A European model. Consciousness and Cognition, 20, 784 791. doi:10.1016/j.concog.2010.129 

• Submitter:  

St. John’s wort extract 

Treatment Summary: Adult patients were evaluated, and those with serious comorbidity, serious physical illness, or high response to placebo were excluded. Patients received 300mg capsules orally twice a day for six weeks. It had good effects on patients, independent of any depressive symptoms. This extract was recommended as being effective, fast, safe and non-sedating. 

• Reference: Volz, H. P., Murck, H., Kasper, S., & M�ller, H. J. (2002). St. John’s wort extract (LI 160) in somatoform disorders: results of a placebo-controlled trial. Psychopharmacology, 164 (3), 294-300. Erratum in Psychopharmacology (2003), 167 (3), 333. 

• Submitter: Martin Friesen 

Treatment Summary: Somatoform disorder is closely associated with anxiety and depression symptoms. It is closely linked to hypochondrias. There are indications that CBT is highly effective treatment. Along with the CBT it is recommended that the patient be treated for any presenting physical symptoms 

• Reference: Piegza, M., Pudlo, R., Badura-Brzoza, K., & Hese, R. T. (2009). Cardiac syndrome X from a psychosomatic point of view. Archives of Psychiatry and Psychotherapy , 23-27. Warner, C. M., Reigada, L. C., Fisher, P. H., Saborsky, A. L., & Benkov, K. J. (2009). CBT for Anxiety and Associated Somatic Complaints in Pediatric Medical Settings: An Open Pilot Study. Journal for Clinical Psychology in Medical Settings , 169-177. 

• Submitter: Leasa Arms 

Cognitive Behavioral Treatment 

Treatment Summary: CBT seems to be the optimal treatment for somatoform as there is no medical explanation but it can be looked at in terms of both responding and operant conditioning. The treatment usually follows 5 steps: 1: Assessment 2: Rationale of treatment choice 3: Course of treatment 4: Evaluation of treatment 5: Reviewing treatment effects. These steps are important because it allows for the individualized treatment where behaviors can be focused on individually identifying the behavior and consequences associated with it. Then the patient can focus on extinguishing or reducing the behavior through multiple techniques. In using CBT the therapist attempts to modify the attitudes and schema associated with previous actions. 

• Reference: Tazaki, M., & Landlaw, K. (2006). Behavioural mechanisms and cognitive-behavioural interventions of somatoform disorders. International Review of Psychiatry, 18(1), 67-73. doi:10.1080/09540260500467046 

• Submitter: Shanna Schopmeyer 

Keishikajutsubuto, Japanese Herbal 

Summary of Treatment: In the study referenced below, a patient with a diagnose of undifferentiated somatoform disorder is given an Japanese herbal treatment of Kampo or Keishikajutsubuto. 

The patients is a 16 year old baseball player who was suffering from coxalgia after attending a baseball camp and coming up with the realization that he might not be as good as the other camper there.  The patient develops leg pain and was not able to walk out of the camp without the assistance of crutches. Although a medical examination conducted by an orthopedist did not support finding of coxalgia, the pain relievers given to the patient did not help nor reduce the pain. The patient was referred out and given psychotherapy. The patient was diagnosed with undifferentiated somatoform and given serotonin. 

The treatment of serotonin was ineffective.  The patient was reevaluated and given Kampo, a Japanese herbal treatment.  The patient had movement of his leg improvement within two weeks of taking the Kampo medicine and the diminishing of pain and the use of the crutches within 6 weeks. 

Keishikajutsubuto, Japanese Kampo, is an herbal treatment that is composed of seven herbs. 

• Reference: Okamoto, H., Sekiya, N., Chino, A., Iyo, M., & Terasawa, K. (2011). A Suspected Case of Somatoform Disorder Successfully Treated with an Herbal Medicine. Journal Of Alternative & Complementary Medicine, 17(2), 171-173. doi:10.1089/acm.2010.01