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Somatoforme und funktionelle Störungen

Somatoform disorders and functional somatic syndromes

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Zusammenfassung

Somatoforme Beschwerden zeichnen sich durch anhaltende und subjektiv beeinträchtigende Körperbeschwerden aus, für die auch nach angemessener somatischer Diagnostik keine ausreichende organmedizinische Erklärung gefunden werden kann. Die Prävalenzraten somatoformer Beschwerden und Störungen sind vor allem in der Primärversorgung beträchtlich. Der Verlauf der Störung ist typischerweise chronisch, die Remissionsraten sind niedrig. Die Genese und Aufrechterhaltung somatoformer Beschwerden sind als multifaktoriell anzusehen. Die Klassifikation somatoformer Störungen wird aktuell kontrovers diskutiert; es ist von einer deutlichen Änderung der Kategorie im künftigen DSM-V auszugehen. Hinsichtlich der Psychotherapie somatoformer Störungen liegt empirische Evidenz für die Wirksamkeit kognitiv-behavioraler sowie psychodynamischer Therapieansätze vor. Die Pharmakotherapie hat eine nachgeordnete Bedeutung, kann aber bei ausgeprägter Komorbidität von Angst- oder depressiven Störungen sinnvoll sein.

Summary

Somatoform symptoms occur in the absence of clear organic pathology. Typically, such symptoms are long-lasting and disabling. Somatoform symptoms and disorders are highly prevalent in primary care. The course of somatoform disorders is mostly chronic, and remission rates are low. Multiple factors influence the development and perpetuation of somatoform disorders. Currently, there is strong debate about the classification of somatoform disorders, and it is very likely that there will be significant changes in the classification of somatoform disorders in the upcoming DSM-V. With regard to the psychotherapeutic treatment of somatoform disorders, there is empirical evidence for the efficacy of cognitive-behavioral as well as psychodynamic-interpersonal strategies. Pharmacotherapy plays a minor role, but it can be useful mainly in cases of comorbid depression or anxiety.

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  1. Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar der TU München, Langerstraße 3, 81675, München, Deutschland

    C. Lahmann, P. Henningsen & A. Dinkel

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  1. C. Lahmann
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Correspondence to C. Lahmann.

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Lahmann, C., Henningsen, P. & Dinkel, A. Somatoforme und funktionelle Störungen. Nervenarzt 81, 1383–1396 (2010). https://doi.org/10.1007/s00115-010-3056-y

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