Symptoms somatic

Three characteristic types of symptoms—somatic, perceptual, and psychic— have followed use of members of the LSD group of hallucinogens. In repeated laboratory experiments, subjects report a basic clinical syndrome that might be described as follows ... 

Somatic anxiety Suicide Genital symptoms Somatic symptoms Agitation... 

Stigma and misinformation can also extend into medical practice, where many depressed patients present with medically unexplained symptoms. Somatization is the term used for such use of physical symptoms to express emotional distress, which may be a major reason for misdiagnosis of mental illness by medical and psycho-... 

Common symptoms Somatic symptoms Psychotic symptoms... 

Anxiolytic. A drug that decreases the mental symptoms and somatic signs of anxiety. 

Dependence is a somatic state which develops after chronic administration of certain dtugs. This condition is characterized by the necessity to continue administration of the drug to avoid the appearance of withdrawal symptoms. Withdrawal symptoms are relieved by the administration of the drug upon which the body was dependent . Psychological dependence is due to (e.g., social) reinforcement processes in the maintenance of drug-seeking behavior. 

Depression and mania are both affective disorders but their symptoms and treatments are quite distinct. Mania is expressed as heightened mood, exaggerated sense of self-worth, irritability, aggression, delusions and hallucinations. In stark contrast, the most obvious disturbance in depression is melancholia that often co-exists with behavioural and somatic changes (Table 20.1). Some individuals experience dramatic mood swings between depression and mania. This is known as "bipolar disorder which, like mania itself, is treated with lithium salts or neuroleptics. 

Somatic upsets are the primary symptoms of depression among the Chinese, in contrast to the affective and dysphoric manifestations that are more common in the West (Cheung Bernard, 1982 Kleinman, 1977,1988 Marsella, Kinzie 8c Gordon, 1973 Tseng, 1975). 

Concerns about psychotropic side effects, which can vary cross-culturally, often lead to premature cessation of psychotropics. This may be related to different propensities for and values placed on somatic experiences in different cultures. Transcultural research indicates that patients from non-Western cultures are more likely to present with predominantly somatic symptoms of psychiatric disorders (Ng, 1997 Parker, Gladstone 8c Chee, 2001), as cultural explanatory models and social demands may serve to bias information processing in the various domains of subjective experience (Angel 8c Thoits, 1987). Several studies have shown that the perception and reporting of side effects are influenced by cultural beliefs... 

The classic symptoms of depression are listed in Table 12.1, which is based on DSM-IV criteria. For a diagnosis of major depressive disorder, most of these symptoms must be present, including the first two (APA, 2000). These symptoms should be of sufficient intensity and chronic duration (at least 2 weeks) to cause clinically significant distress and impairment in social or economic functioning. However, they should not be a result of another psychiatric or somatic illness, nor of drug misuse or bereavement. For a diagnosis of mania, the symptoms are a mirror image of those for depression (Table... 

Sub-clinical mastitis, on the other hand, has no visible symptoms and can only be diagnosed with laboratory methods (Wendt et al., 1994) (see below). The diagnosis of sub-clinical mastitis depends on two parameters, the microbiological profile of sampled milk and the somatic cell count (Hamann and Fehlings, 2002). The different severity levels of mastitis and symptoms used in diagnosis are described in Table 11.3. 

The BZs are the most frequently prescribed drugs for the treatment of acute anxiety (Table 68-9). All BZs are equally effective anxiolytics, and most of the improvement occurs in the first 2 weeks of therapy. They are considered to be more effective for somatic and autonomic symptoms of GAD, while antidepressants are considered more effective for the psychic symptoms (e.g., apprehension and worry). 

Beach and Amir have demonstrated that with a given sample using the same procedures, some markers of depression may define a taxon, while others do not. In other words, both continuous and taxonic forms of depression exist. However, questions remain about the nature of the identified taxon. Is it really a depression taxon or has the exclusive focus on vegetative symptoms changed the nature of the construct Interestingly, certain somatic symptoms, such as sleep and appetite disturbance, are common in many disorders and can be considered the physical component of nonspecific distress (Clark Watson, 1991). Thus, perhaps the identified taxon is not a depression taxon at all and actually reflects general somatic complaints. Only construct validation can address these concerns. 

Somatic symptoms dizziness, weakness, tremors, nausea, drowsiness, paresthesias, and blurred vision. 

The clinical syndrome tends to follow a sequential pattern, with somatic symptoms presenting first, perceptual and mood changes next, and, finally, psychic changes, although there is considerable overlap between these phases (Table 1). Between the range of 1 to 16 Mg/kg, the severity of psychophysiologic effects of LSD in a given subject are proportional to the dose (30). Specific types of reaction, such as paranoid ideation, are more likely a matter of personal predisposition than a function of dose. 

Hopkins Symptom Checklist. The Hopkins Symptom Checklist (HSCL) is a scale that has been used to measure the presence and intensity of various symptoms in outpatient neurotic patients. It is a 58-item self-rating scale and has generally been replaced by the Self-Report Symptom Inventory (SCL-90). It measures the symptoms during the past week and requires approximately 20 minutes to complete. There are five subtests somatization, obsessive-compulsive, interpersonal sensitivity, depression, and anxiety. 

Self-Report Symptom Inventory. Each of the 90 items in the SCL-90 uses a five-point scale of distress. It was designed as a general measure of symptomatology for use by adult psychiatric outpatients in either a research or clinical setting. It rates either the present or previous week. It requires about 15 minutes for the patient to complete this form and about 5 minutes for a technician to verify identifying information. This test is sensitive to drug effects and may be used with inpatients. Nine subscales are measured somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid ideation, and psychoticism. 

Based on structural similarities, the neuropharmacological mechanisms of morning glory alkaloids are likely similar or identical to those of LSD. The subjective effects are also similar, but the lower potency of the alkaloids requires larger doses for hallucinogenic effects. Somatic effects tend to be pronounced, with nausea and gastrointestinal symptoms being very common. 

Hubner WD, Lande S, Podzuweit H. (1994). Hypericum treatment of mild depressions with somatic symptoms. J Geriatr Psychiatry Neurol. 7(suppl 1) S12-4. 

SSRls and SNRIs. The SSRl antidepressants, together with venlafaxine, have replaced the benzodiazepines as treatments of choice for GAD. Paroxetine and escitalopram are FDA approved for GAD, though it is generally believed that all SSRls and SNRIs are effective for GAD. Similar to the TCAs, SSRIs/SNRIs appear to be most effective for the intrapsychic symptoms of GAD but less effective than benzodiazepines for the somatic manifestations of the disorder. 

Major depression is a triad of psychological, somatic and physical symptoms. Over 75% of depressed patients report painful physical symptoms involving the neck, back, head, stomach and the skeleto-muscular system. Not only can chronic pain lead to depression, but also vice versa. 

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