Funktionelle Symptome und somatoforme Störungen in der Notaufnahme: Ein unterrepräsentierter Bereich der Notfallmedizin

Background: Functional somatic symptoms and somatoform disorders are common in community samples. Persons troubled with these symptoms are characterized by an excessive use of health care resources. Thus, it seems probable that they will also attend the emergency department. Objectives: The aim of this article is to introduce the topic of functional somatic symptoms and to critically discuss the current state of research on functional somatic symptoms in the emergency department. Materials and methods: Selective, narrative review. Results: Empirical evidence concerning functional somatic symptoms and somatoform disorders in the emergency department is limited. The prevalence rates range between 2.9 and 16.5 %. Structural characteristics of the emergency department, especially the focus on the rule out of medical conditions, represent barriers for the early identification and proactive management of these patients. The current German clinical practice guideline on nonspecific, functional and somatoform bodily complaints provides information on diagnosis, which is also important for the management of these patients in emergency medicine. Main issues are avoiding iatrogenic chronification, early consideration of psychosocial factors and cooperation with psychosomatic consultation-liaison services. Conclusion: Functional somatic symptoms and somatoform disorders represent a challenge to patient management in the emergency department. There is a need for well-founded studies on occurrence and management of these patients in the emergency department.