Somatoform disorders account for a large amount of business for most family physicians. These are conditions that have no obvious patho-physiological explanation. They include: hypochondriasis, psycho-somatic illness, Briquet’s syndrome (somatization disorder), body dysmorphic disorder, conversion disorder, pain disorder, and hysteria. These are all conditions in which the patient is not malingering or making up symptoms, such as in Munchhausen’s syndrome, but are complaining of symptoms that have no underlying physical cause. Usually there is a psychological component and the patient needs to be treated with a behavioral approach.
Placebo Medicine (alternative, complementary, integrative, etc.) should be a treatment of choice for this category of conditions provided there is no deception and a work-up has ruled out the majority of possible physiological causes.
Many physicians argue that deception in medicine is unacceptable and I agree but deception is not required for Placebo Medicine to work. It works just as well, and often better, with a fully informed patient. Furthermore, we now have the knowledge of how and why “suggestion” can effect brain systems in a way that is therapeutic. This knowledge can be honestly conveyed to the patient and the treatment will still work. Patients who it works the best for are those that have somatoform disorders.
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