Somatic Symptoms Quotes

“Psychologisation describes the emphasis on psychological factors where there is little or no evidence to justify it (1). It's a process where relevant findings are ignored or downplayed in favour of data from incomplete examinations, flawed research or anecdotal reports.
In a clinical context, differential diagnoses may be dismissed prematurely while psychological explanations are readily accepted.
Psychologisation does not refer to situations where there is sound evidence that psychological factors play a significant role, or where all the arguments are discussed and the psychological explanations are deemed the most persuasive.”
― Ellen Goudsmit

“The case of a patient with dissociative identity disorder follows:

Cindy, a 24-year-old woman, was transferred to the psychiatry service to facilitate community placement. Over the years, she had received many different diagnoses, including schizophrenia, borderline personality disorder, schizoaffective disorder, and bipolar disorder. Dissociative identity disorder was her current diagnosis.

Cindy had been well until 3 years before admission, when she developed depression, "voices," multiple somatic complaints, periods of amnesia, and wrist cutting. Her family and friends considered her a pathological liar because she would do or say things that she would later deny. Chronic depression and recurrent suicidal behavior led to frequent hospitalizations. Cindy had trials of antipsychotics, antidepressants, mood stabilizers, and anxiolytics, all without benefit. Her condition continued to worsen.

Cindy was a petite, neatly groomed woman who cooperated well with the treatment team. She reported having nine distinct alters that ranged in age from 2 to 48 years; two were masculine. Cindy’s main concern was her inability to control the switches among her alters, which made her feel out of control. She reported having been sexually abused by her father as a child and described visual hallucinations of him threatening her with a knife. We were unable to confirm the history of sexual abuse but thought it likely, based on what we knew of her chaotic early home life.

Nursing staff observed several episodes in which Cindy switched to a troublesome alter. Her voice would change in inflection and tone, becoming childlike as ]oy, an 8-year-old alter, took control. Arrangements were made for individual psychotherapy and Cindy was discharged.

At a follow-up 3 years later, Cindy still had many alters but was functioning better, had fewer switches, and lived independently. She continued to see a therapist weekly and hoped to one day integrate her many alters.”
― Donald W. Black, Introductory Textbook of Psychiatry, Fourth Edition

“It must be noted that there is no proof that it is justified to apply the label somatisation to such conditions as chronic fatigue syndrome and several more illnesses that established medicine has so for failed to explain scientifically. ……Don't hesitate to ask questions about scientific evidence behind this talk about somatisation. Be persistent, because a diagnosis of somatisation is definitely not an innocuous label. It will close various doors and lead (to) treatments that usually get nowhere.”
― Per Dalén

“There is no specific test for multiple sclerosis.  Its early symptoms - fatigue, loss of sensation, weakness and visual changes - are frequently misdiagnosed as psychoneurosis or an even more severe psychiatric disorder, such as hysteria, particularly in women.
When doctors could find no organic cause for [Jacqueline Du Pré's] complaints, they prescribed a year's rest, and referred her to a psychiatrist... When she consulted a doctor in Australia about her tenacious fatigue and occasional double vision in her right eye, he dismissed her symptoms as "adolescent trauma" and suggested she take up a relaxing hobby.”
― Carol Easton, Jacqueline du Pré: A Life