The Psychological Factors in Medically Unexplained Symptoms

Medically unexplained symptoms, somatization, somatic symptom disorder, somatofrom disorders, bodily distress disorder, nociplastic symptoms, primary pain, etc. are all terms and diagnoses of what we now call neuroplastic symptoms. I want to go over a  paper here from 2022 titled: “Recent developments on psychological factors in medically unexplained symptoms and somatoform disorders.”

The author states: “Pain, gastrointestinal, cardiovascular, or other somatic symptoms which are not fully explained by a medical condition (medically unexplained symptoms), are very common both in the general population and in patients in health care.” These are the neuroplastic conditions I treat in my practice. The author says rightfully so: “Since persistent medically unexplained somatic symptoms and somatoform disorders bring about high costs for health care systems and are among the leading causes of disability, it is highly relevant to investigate psychological factors that characterize and influence these symptoms and disorders.” I agree that the more we understand what factors are influencing and contributing to neuroplastic symptoms, the more we know what to address for treatment success.

What are these psychological factors? The paper states: “Evidence suggested that in addition to more unspecific factors such as early childhood trauma or insecure attachment, specific negative psychological factors such as catastrophizing, negative affectivity, rumination, avoidance, health anxiety, or a negative physical self-concept have a substantial influence on the transition from unproblematic medically unexplained somatic symptoms to severely impairing complaints and somatoform disorders.”

So based on this evidence, let’s lay out here what we can look to address when dealing with neuroplastic symptoms:

-the past (childhood- trauma, insecure attachment)

-negative thinking (catastrophizing, rumination)

-emotions (negative affectivity, health anxiety)

-actions/behaviors (avoidance)

-self worth/self-esteem (negative physical self-concept)

The paper highlights that “the findings underlined the importance to consider negative psychological factors in the context of medically unexplained symptoms, as these factors may have the potential to explain why medically unexplained somatic symptoms cause so much impairment without a (known) underlying medical disease.” I think it’s so important to understand from the evidence and then to believe that the brain can cause these very real symptoms, but that the cause can come from psychological factors instead of physical factors. We want to then address these psychological factors as a way to treat and diminish the medically unexplained symptoms. Reach out if want help in doing this.