Treatment
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Relationship with primary care practitioner
Because patients with somatoform disorders often have lengthy medical histories, a long-term relationship with a trusted primary care practitioner (PCP) is a safeguard against unnecessary treatments as well as a comfort to the patient. Many PCPs prefer to schedule brief appointments on a regular basis with the patient and keep referrals to specialists to a minimum. This practice also allows them to monitor the patient for any new physical symptoms or diseases. However, some PCPs work with a psychiatric consultant.
Medications
Patients with somatoform disorders are sometimes given antianxiety drugs or antidepressant drugs if they have been diagnosed with a coexisting mood or anxiety disorder. In general, however, it is considered better practice to avoid prescribing medications for these patients since they are likely to become psychologically dependent on them. However, body dysmorphic disorder as been successfully treated with selective serotonin reuptake inhibitors (SSRI) antidepressants.
Psychotherapy
Patients with somatoform disorders are not considered good candidates for psychoanalysis and other forms of insight-oriented psychotherapy. They can benefit, however, from supportive approaches to treatment that are aimed at symptom reduction and stabilization of he patient's personality. Some patients with pain disorder benefit from group therapy or support groups, particularly if their social network has been limited by their pain symptoms. Cognitive-behavioral therapy is also used sometimes to treat pain disorder.
Family Therapy
Family therapy is usually recommended for children or adolescents with somatoform disorders, particularly if the parents seem to be using the child as a focus to divert attention from other difficulties. Working with families of chronic pain patients also helps avoid reinforcing dependency within the family setting.
Hypnosis is a technique that is sometimes used as part of a general psychotherapeutic approach to conversion disorder because it may allow patients to recover memories or thoughts connected with the onset of the physical symptoms.
Alternative treatment
Patients with somatization disorder or pain disorder may be helped by a variety of alternative therapies including acupuncture, hydrotherapy, therapeutic massage, meditation, botanical medicine, and homeopathic treatment. Relief of symptoms, including pain, can occur on the physical level, as well as on the mental, emotional, and spiritual levels.
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