Mood disorders. Prevalence and course of unspecified functional disorders from the epidemiologic and psychosomatic viewpoint

Subjective complaints or somatoform symptoms beyond the case threshold (ICD-diagnoses) occur in 12% of the normal population. In recent studies prevalence is at least 17% in primary care. Somatoform complaints (e.g. headache with 38.7%) or non-specific common symptoms (e.g. feeling of inner restlessness with 41.3%) are much more widespread. Mostly, several symptoms together are forming a multiple somatoform syndrome. As well known from other psychogenic disorders, spontaneous long-term course of somatoform symptoms is variable due to the psychic co-morbidity (in particular anxiety and depression) and a strong tendency to symptomatic shift. The long-term course of total impairment by additional psychogenic symptoms is rather bad in somatoform disorders. Clinically significant personality traits and traumatic influences during early childhood development are correlated with somatoform disorders. Within the traditional role patterns of the relation between physician and patient, somatoform complaints often communicate or indicate a psychodynamic conflict. In this case, a psychosomatic/psychotherapeutic approach in primary care or a specialized psychotherapy is indicated.