Article

We report 124 cases of somatoform disorders, considering psychogenic disorders at
the same level as neurological disorders. We noted any psychic, somatic or social
condition (history taking) and facilitating circumstances.
The patients were aged
16 to 84 years old; 71.7% were women. We observed pain (35.4%), psychogenic
headache (25%), sensorimotor loss (27.4%), gait and psychogenic tremor (17.7%),
cognitive disorders (11.8%), ocular symptoms (7.2%), and urogenital symptoms
(2.4%). Delay to consultation ranged from a few days to 20 years. Psychiatric
comorbidity was noted in 30.6% of the cases. In 55.6% of 124 cases, we observed a
psychological background. It was a childhood trauma in 15.3% of these cases. In
one-third of the 124 situations, we noted an underlying somatic or social
condition. Facilitation conditions were frequently mixed. Somatic and/or
psychological conditions were noted in one-third of the 124 cases and social
conditions in half of them. The neurologist is faced with the challenge of naming
the symptom (most often labelled a functional disorder) and of making the
decision to stop or limit investigations. Visits by patients with psychogenic
disorders make up a significant percentage of neurology speciality appointments.
The neurologist should not limit the consultation to differentiating "real"
symptoms from psychogenic somatoform disorders, but should also propose a
straightforward compassionate approach for effective therapeutic care. By
carefully listening to the patient's dialogue, the neurologist can help the
patient give meaning to the symptoms, and progress towards improved well-being.
CI - Copyright (c) 2012 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS