DIAGNOSIS AND TREATMENT OF SOMATOFORM AUT ONOMOUS FUNCTIONAL-DISORDERS - A LITERATURE-REVIEW

This review presents historical aspects, terminology and diagnostical procedures of somatoform autonomous functional disorders (SAF) as incl uded in the ICD-10, particularly in relation to the other somatoform d isorders. Empirical studies showing the relevance of comorbidity and i llness-behaviour, the role of psychosocial factors, prognosis and empi rical proved therapy are illustrated. Therapy-relevant conclusions fol low. Most studies are done in the subcategory SAF of the gastrointesti nal system. The high placebo-response-rates in the controlled studies show that repetitive contacts as used in study designs reduce complain ts. Studies in psychotherapy prove the efficacy of information on the disease, relaxation techniques, stress management and conflict-centred talks. SAF of the cardiovascular system are improved by cognitive beh avioural therapy, as some studies show, SAF of the respiratory system improve by biofeedback. There is a lack of studies on SAF of the uroge nital system. There are only a few studies on pharmacotherapy on patie nts with SAF with short observation periods, symptoms relapse regularl y often stopping the medication. Research desiderata are formulated.