Management of Functional Somatic Syndromes and Bodily Distress

Peter Henningsen, Stephan Zipfel, Heribert Sattel, Francis Creed

Research output: Contribution to journalReview articlepeer-review

226 Scopus citations

Abstract

Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease. This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years. We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

Original languageEnglish
Pages (from-to)12-31
Number of pages20
JournalPsychotherapy and Psychosomatics
Volume87
Issue number1
DOIs
StatePublished - 1 Jan 2018

Keywords

  • Bodily distress
  • Functional somatic syndromes
  • Management
  • Review

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