Treatment

The way in which somatoform illness is treated depends largely on the nature of the individual and his or her symptoms. Where appropriate, efforts are made to resolve any psychosocial problems that may have provoked the presenting symptoms. Symptomatic treatments, such as physiotherapy, orthopedic treatment, occupational therapy, and speech therapy, are often used to reduce loss of function and disability and to prevent secondary damage. Other approaches, such as pain management techniques, are used to ameliorate the distress caused by symptoms. Where appropriate, depression and anxiety are treated using medication. Often, the use of these and other techniques, combined with a careful management approach, is sufficient to provide the patient with lasting symptomatic relief. In some cases, however, more specific psychological treatment is necessary. In such cases, cognitive-behavioral therapy is most commonly used, typically targeting maladaptive beliefs about health and illness, behavioral patterns that maintain symptoms, and social factors that reinforce them. Cognitive-educational therapy, typically aimed at informing patients about the relationship between symptoms and psychological processes, is also sometimes used, often in a group context. Insight-oriented psychotherapy may be used in cases in which emotional issues appear to be a significant pathogenic factor. In terms of efficacy, evidence suggests that a cognitive approach is often effective in the treatment of somatoform illness; however, very few data exist on the efficacy of psychotherapy in these conditions.

In cases in which symptomatic and psychological interventions fail to provide complete resolution of the patients' symptoms, it may be necessary to adjust the therapeutic goal from curing the patients to simply caring for them. Accordingly, management should aim to contain the patients' symptoms and distress, limit their health care utilization, and prevent iatrogenic damage.

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