Persistent physical symptoms: definition, genesis, and management
Standard
Persistent physical symptoms: definition, genesis, and management. / Löwe, Bernd; Toussaint, Anne-Kristin; Rosmalen, Judith G M; Huang, Wei-Lieh; Burton, Christopher; Weigel, Angelika; Levenson, James; Henningsen, Peter.
in: LANCET, Jahrgang 403, Nr. 10444, 15.06.2024, S. 2649-2662.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Persistent physical symptoms: definition, genesis, and management
AU - Löwe, Bernd
AU - Toussaint, Anne-Kristin
AU - Rosmalen, Judith G M
AU - Huang, Wei-Lieh
AU - Burton, Christopher
AU - Weigel, Angelika
AU - Levenson, James
AU - Henningsen, Peter
PY - 2024/6/15
Y1 - 2024/6/15
N2 - Persistent physical symptoms (synonymous with persistent somatic symptoms) is an umbrella term for distressing somatic complaints that last several months or more, regardless of their cause. These symptoms are associated with substantial disability and represent a major burden for patients, health-care professionals, and society. Persistent physical symptoms can follow infections, injuries, medical diseases, stressful life events, or arise de novo. As symptoms persist, their link to clearly identifiable pathophysiology often weakens, making diagnosis and treatment challenging. Multiple biological and psychosocial risk factors and mechanisms contribute to the persistence of somatic symptoms, including persistent inflammation; epigenetic profiles; immune, metabolic and microbiome dysregulation; early adverse life experiences; depression; illness-related anxiety; dysfunctional symptom expectations; symptom focusing; symptom learning; and avoidance behaviours, with many factors being common across symptoms and diagnoses. Basic care consists of addressing underlying pathophysiology and using person-centred communication techniques with validation, appropriate reassurance, and biopsychosocial explanation. If basic care is insufficient, targeted psychological and pharmacological interventions can be beneficial. A better understanding of the multifactorial persistence of somatic symptoms should lead to more specific, personalised, and mechanism-based treatment, and a reduction in the stigma patients commonly face.
AB - Persistent physical symptoms (synonymous with persistent somatic symptoms) is an umbrella term for distressing somatic complaints that last several months or more, regardless of their cause. These symptoms are associated with substantial disability and represent a major burden for patients, health-care professionals, and society. Persistent physical symptoms can follow infections, injuries, medical diseases, stressful life events, or arise de novo. As symptoms persist, their link to clearly identifiable pathophysiology often weakens, making diagnosis and treatment challenging. Multiple biological and psychosocial risk factors and mechanisms contribute to the persistence of somatic symptoms, including persistent inflammation; epigenetic profiles; immune, metabolic and microbiome dysregulation; early adverse life experiences; depression; illness-related anxiety; dysfunctional symptom expectations; symptom focusing; symptom learning; and avoidance behaviours, with many factors being common across symptoms and diagnoses. Basic care consists of addressing underlying pathophysiology and using person-centred communication techniques with validation, appropriate reassurance, and biopsychosocial explanation. If basic care is insufficient, targeted psychological and pharmacological interventions can be beneficial. A better understanding of the multifactorial persistence of somatic symptoms should lead to more specific, personalised, and mechanism-based treatment, and a reduction in the stigma patients commonly face.
U2 - 10.1016/S0140-6736(24)00623-8
DO - 10.1016/S0140-6736(24)00623-8
M3 - SCORING: Review article
C2 - 38879263
VL - 403
SP - 2649
EP - 2662
JO - LANCET
JF - LANCET
SN - 0140-6736
IS - 10444
ER -