Persistent somatoform pain disorder (ASD)


Pain disorder, psychalgia

English term: pain disorder, somatoform pain disorder


As asustaining somatoform S.pain disorder (ASS) is a disorder characterized by persistent strong pain without somatic (physical) Cause is identified so that psychological causes are viewed as triggers (emotional conflicts, psychosocial problems).


There can be multiple causes persistent somatoform pain disorder cause. Accordingly, it is less individual factors than an interplay of different factors that lead to this pain disorder.
Such factors are neurophysiological (e.g. differences in pain perception and pain transmission), theoretical learning (e.g. learning on a model - observational learning), personality-specific (e.g. processing stress) and social nature (e.g. culture).


The physiological causes of the pain should first be checked by a doctor (neurological = Specialist in neurology) Investigation can be excluded.

The pain leads to enormous suffering, so that more personal or medical help is sought. Based on the guidelines for psychotherapeutic medicine and Psychosomatics (2002) should also provide a precise medical history (prehistory), as factors such as physical abuse appear more often in the biography of those affected. Patients with a psychological cause of their pain do not localize it precisely, describe the pain more emotionally and less with sensory terms (e.g. "burning", "pulling", etc.)

The pain symptoms must correspond to the ICD guidelines exist for more than six months. The psychological triggers of the ASS (persistent somatoform pain disorder) must be differentiated from those psychological stress factors that only developed in the course of ASA (persistent somatoform pain disorder). In doing so, no pain conditions should be taken into account that are part of a depressive disorder or schizophrenia appeared. Furthermore, there should be no evidence of simulation.


The first step one therapy The persistent somatoform pain disorder consists first of all in the prevention of unnecessary measures to eliminate the non-physical pain (e.g. by invasive procedures, i.e. procedures that penetrate the body).
A psychotherapy is the drug of choice for persistent somatoform pain disorder. In a behavioral therapeutic approach, strategies for coping with pain, changing the subjective disease models and changing the function of pain will be in the foreground.
Body-related elements of psychotherapy aim to change body awareness and mindfulness. Psychodynamic elements, on the other hand, focus on early childhood trauma and the mechanism of somatization, i.e. emotional conflicts show up in physical symptoms.

In addition to psychotherapy, it is useful antidepressant drugs (Amitriptyline) to be administered. Tranquilizers (sedatives) or neuroleptics (drugs for the treatment of psychoses, e.g. the schizophrenia) should not, however, be administered.