Klinischer und diagnostischer Stellenwert von Schmerzsymptomen bei 274 Patienten einer neurologischen Universitätsklinik mit psychogenen Symptomen
The psychogenic pain disorder is a diagnosis of its own besides the conversion disorder since 1977. In the actual retrospective study clinical and sociodemographic features are examined between the patients with psychogenic pain and the patients with different psychogenic symptoms. Pain is a frequent psychogenic symptom. In this study 32,5% of the 274 patients with psychogenic symptoms had pain as leading symptom. Taking leading and accompanying symptoms together even 63,5% reported pain. Comparing the patients with pain as leading psychogenic symptom versus the patients with a different leading symptom than pain there did not show significant differences concerning most of the examined sociodemographic and clinical features. But there were some the groups differentiating aspects: Patients with psychogenic pain showed more frequent depressions and were prescribed more frequent antidepressive medication. They reported more frequent a long-standing disturbance (> 30 days) at the index-examination and showed more frequent a chronification as well as attempted more suicides. After a duration of more than six months and more than two years a detoriation of the prognosis was found. A psychogenic pain disorder should therefore be diagnosed in the first six months in order to make an early therapeutic intervention possible. To demand a duration of six months for diagnosing a somatoform pain disorder is not helpful, as demanded in the ICD-10 and the DSM-III-R. Regarding the differences it is reasonable to have psychogenic pain as a disorder of its own besides the conversion or dissociative disorder. The patients, who had a different leading psychogenic symptom than pain, were diagnosed a dissociative disorder according to ICD-10 in 80,0% of the cases studied. 42,6% of them had accompanying psychogenic pain. In 38,5% the pain was not included by the diagnosis, since it is excluded in the ICD-10. It seams reasonable to divide psychogenic pain in subgroups, for example regarding their etiology. One subgroup could be regarded part of the dissociative disorders.
info:eu-repo/classification/ddc/610, Medizin, Beschreibung der Somatoformen Schmerzstörung und Abgrenzung zu anderen psychogenen Störungen
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