Skip to main content

Treatment of Psychosomatic Symptoms

  • Chapter
  • First Online:
Medically Unexplained Symptoms
  • 598 Accesses

Abstract

People with psychosomatic symptoms do best within a structured lifestyle that includes regular physical exercise, adequate time for sleep, healthy eating habits and stress management techniques such as mindfulness, yoga and tai chi. Cognitive-behavioral therapy can help patients recognize and modify thoughts and activities that trigger symptoms. Numerous drugs, including antidepressants, antiepileptics and anxiolytics, are used to treat psychosomatic symptoms, but none have been dramatically effective. A major limitation of these drugs is “off-target effects” that lead to bothersome side effects and variable response. Transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are promising new treatments for a variety of psychosomatic illnesses, but well-controlled treatment trials are needed to access efficacy and safety.

It may well be to the shareholder’s advantage for pharmaceutical companies to promote medications for an ever-increasing array of human problems, but this in no way insures that these constitute improvements in health and medical care.

Peter Conrad [1]

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 14.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 22.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Conrad P. The shifting engines of medicalization. J Health Soc Behav. 2005;46:11.

    Article  Google Scholar 

  2. Herring BP, Puetz TW, O’Conner PJ, Dishman RK. Effect of exercise training on depressive symptoms and meta-analysis of randomized controlled trials. Arch Intern Med. 2012;172:101–11.

    Article  PubMed  Google Scholar 

  3. Stonerock GL, Hoffman BM, Smith PJ, Blumenthal JA. Exercise as treatment for anxiety: systematic review and analysis. Ann Behav Med. 2015;49:542–56.

    Article  PubMed  Google Scholar 

  4. Roeh A, Kirchner SK, Malchow B, et al. Depression in somatic disorders: is there a beneficial effect of exercise. Front Psych. 2019;10:141.

    Article  Google Scholar 

  5. Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry. 2018;5:739–46.

    Article  PubMed  Google Scholar 

  6. Xu Z, Hu M, Wang Z, et al. The positive effect of moderate-intensity exercise on the mirror neuron system: an fNIRS study. Front Psychol. 2019;10:986.

    Article  PubMed  PubMed Central  Google Scholar 

  7. James W. The principles of psychology. New York: Holt; 1890.

    Google Scholar 

  8. Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of meditation studies. Clin Psychol Rev. 2015;37:1–12.

    Article  CAS  PubMed  Google Scholar 

  9. Hofmann SG, Gomez AF. Mindfulness-based interventions for anxiety and depression. Psychiatr Clin North Am. 2017;40:739–49.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Brewin C. Theoretical foundations of cognitive-behavioral therapy for anxiety and depression. Ann Rev Psychol. 1996;47:33–57.

    Article  CAS  Google Scholar 

  11. Baardseth TP, Goldberg SB, Pace BT, et al. Cognitive-behavioral therapy versus other therapies: Redux. Clin Psychol Rev. 2013;33:395–405.

    Article  PubMed  Google Scholar 

  12. Hofmann SG, Asmundson GJG. Acceptance and mindfulness-based therapy: new wave or old hat? Clin Psychol Rev. 2008;28:1–16.

    Article  PubMed  Google Scholar 

  13. Andersson G, Titov N, Dear BF, et al. Internet-delivered psychological treatments: from innovation to implementation. World Psychiatry. 2019;18:20–8.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Arnberg FK, Linton SJ, Hultcrantz M, et al. Internet-delivered psychological treatments for mood and anxiety disorders: a systematic review of their efficacy, safety, and cost-effectiveness. PLoS One. 2019;9:e98118.

    Article  CAS  Google Scholar 

  15. Kelson J, Rollin A, Ridout B, Campbell A. Internet-delivered acceptance and commitment therapy for anxiety treatment: systematic review. J Med Internet Res. 2019;21:e12530.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hirschfeld RMA. History and evolution of the monoamine hypothesis depression. J Clin Psychiatry. 2000;61(Suppl 6):4–6.

    CAS  PubMed  Google Scholar 

  17. Hillhouse TM, Porter JH. A brief history of the development of antidepressant drugs: from monoamine to glutamate. Exp Clin Psychopharmacol. 2015;23:1–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Shaw DM, Eccleston EG, Camps FE. 5-Hydroxytriptamine in the hind-brain of depressive suicides. Br J Psychiatry. 1967;113:1407–11.

    Article  CAS  PubMed  Google Scholar 

  19. Wong DT, Perry KW, Bymaster FP. The discovery of fluoxetine hydrochloride (Prozac). Nat Rev Drug Discov. 2005;4:764–74.

    Article  CAS  PubMed  Google Scholar 

  20. Stahl SM, Grady MM, Moret C, Briley M. SNRIs: their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants. CNS Spectr. 2005;10:732–47.

    Article  PubMed  Google Scholar 

  21. Dworkin RH, Corbin AE, Young JP Jr, et al. Pregabalin for the treatment of postherpetic neuralgia: a randomized, placebo-controlled trial. Neurology. 2003;60:1274–83.

    Article  CAS  PubMed  Google Scholar 

  22. Lauria-Horner BA, Pohl RB. Pregabalin: a new anxiolytic. Expert Opin Investig Drugs. 2003;12:663–72.

    Article  CAS  PubMed  Google Scholar 

  23. Stahl SM. Don’t ask, don’t tell, but benzodiazepines are still the leading treatments for anxiety disorder. J Clin Psychiatry. 2002;63(9):756–7.

    Article  PubMed  Google Scholar 

  24. Livingston MG. Benzodiazepine dependence. Br J Hosp Med. 1994;51(6):281–6.

    CAS  PubMed  Google Scholar 

  25. Notaras M, van den Buuse M. Brain –derived neurotrophic factor (BDNF): novel insights into regulation and genetic variation. Neuroscientist. 2019;25:434–54.

    Article  CAS  PubMed  Google Scholar 

  26. Berman RM, Cappiello A, Anand A, et al. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000;47:351–4.

    Article  CAS  PubMed  Google Scholar 

  27. Johnson C. A ketamine revolution for depression and pain? Spravato, fibromyalgia and ME/CFS. www.healthrising. Blog, 2019/04/20.

  28. Deyama S, Duman R. Neurotrophic mechanisms underlying the rapid and sustained antidepressant action of ketamine. Pharmacol Biochem Behav. 2020;188:1–9.

    Article  CAS  Google Scholar 

  29. Niesters M, Martini C, Dahan A. Ketamine for chronic pain: risks and benefits. Br J Clin Pharmacol. 2013;77:357–67.

    Article  CAS  Google Scholar 

  30. Tambaro S, Bortolato M. Cannabinoid-related agents in the treatment of anxiety disorders: current knowledge and future perspectives. Recent Pat CNS Drug Discov. 2012;7:25–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Bhattacharyya S, Morrison PD, Fusar-Poli P, et al. Opposite effects of delta-9-tetrahydrocannabinol and cannabidiol on human brain function and psychopathology. Neuropsychopharmacology. 2010;35(3):764–74.

    Article  CAS  PubMed  Google Scholar 

  32. ElSohly MA, Slade D. Chemical constituents of marijuana: the complex mixture of natural cannabinoids. Life Sci. 2005;78:539–48.

    Article  CAS  PubMed  Google Scholar 

  33. Karschner EL, Darwin WD, McMahon RP, et al. Subjective and physiological effects after controlled Sativex and oral THC administration. Clin Pharmacol Ther. 2011;89:400–7.

    Article  CAS  PubMed  Google Scholar 

  34. Millman RB, Sbriglio R. Patterns of use and psychopathology in chronic marijuana users. Psychiatr Clin North Am. 1986;9:533–45.

    Article  CAS  PubMed  Google Scholar 

  35. Hall W, Solowij N. Adverse effects of cannabis. Lancet. 1998;352:1611–6.

    Article  CAS  PubMed  Google Scholar 

  36. Murray RM, Morrison PD, Henquet C, Di Forti M. Cannabis, the mind and society: the harsh realities. Nat Rev Neurosci. 2007;8:885–95.

    Article  CAS  PubMed  Google Scholar 

  37. Lieberman JA, Ogas O. Shrinks: the untold story of psychiatry. New York: Little, Brown; 2015.

    Google Scholar 

  38. Leiknes KA, Jarosh-von Schweder L, Høie B. Contemporary use and practice of electroconvulsive therapy worldwide. Brain Behav. 2012;2:283–344.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Newman ME, Gur E, Shapira B, Lerer B. Neurochemical mechanisms of action of ECS: evidence from in vivo studies. J ECT. 1998;14:153–71.

    Article  CAS  PubMed  Google Scholar 

  40. Usui C, Doi N, Nishioka M, et al. Electroconvulsive therapy improves severe pain associated with fibromyalgia. Pain. 2006;121:276–80.

    Article  PubMed  Google Scholar 

  41. Kheirabadi G, Vafaie M, Kheirabadi D, et al. Comparative effect of intravenous ketamine and electroconvulsive therapy in major depression: a randomized controlled trial. Adv Biomed Res. 2019;8:25.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  42. Gouveia FV, Gidyk DC, Giacobbe P, et al. Neuromodulation strategies in post-traumatic stress disorder: from preclinical models to clinical applications. Brain Sci. 2019;9:45.

    Article  CAS  PubMed Central  Google Scholar 

  43. Bennabi D, Haffen E. Transcranial direct current stimulation (tDCS): a promising treatment for major depressive disorder. Brain Sci. 2018;8:81.

    Article  PubMed Central  CAS  Google Scholar 

  44. Perera T, George MS, Grammer G, et al. The clinical TMS Society consensus review and treatment recommendations for TMS therapy for major depressive disorder. Brain Stimul. 2016;9:336–46.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Couturier JL. Efficacy of rapid-rate repetitive transcranial magneticstimulation in the treatment of depression: a systematic review and meta-analysis. J Psychiatry Neurosci. 2005;30(2):83–90.

    PubMed  PubMed Central  Google Scholar 

  46. Lo M-C, Widge AS. Closed-loop neuromodulation systems: next-generation treatments for psychiatric illness. Int Rev Psychiatry. 2017;29:191–204.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Greenberg BD, Gabriels LA, Malone DA, et al. Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience. Mol Psychiatry. 2010;15:64–79.

    Article  CAS  PubMed  Google Scholar 

  48. Lavano A, Guzzy G, Della Torre A, et al. DBS in treatment of post-traumatic stress disorder. Brain Sci. 2018;8:18.

    Article  PubMed Central  Google Scholar 

  49. Bina RW, Langevin J-P. Closed loop brain stimulation for PTSD, addiction, and disorders of affective facial interpretation: review and discussion of potential biomarkers and stimulation paradigms. Front Neurosci. 2018;12:300.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Fletcher RR, Tam S, Omojola O, et al. Wearable sensor platform and mobile application for use in cognitive behavioral therapy for drug addiction and PTSD. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:1802–5.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert W. Baloh .

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Baloh, R.W. (2021). Treatment of Psychosomatic Symptoms. In: Medically Unexplained Symptoms. Copernicus, Cham. https://doi.org/10.1007/978-3-030-59181-6_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-59181-6_10

  • Published:

  • Publisher Name: Copernicus, Cham

  • Print ISBN: 978-3-030-59180-9

  • Online ISBN: 978-3-030-59181-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics