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Persistent physical symptoms: definition, genesis, and management.

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Title: Persistent physical symptoms: definition, genesis, and management.
Authors: Löwe, Bernd (AUTHOR), Toussaint, Anne (AUTHOR), Rosmalen, Judith G M (AUTHOR), Huang, Wei-Lieh (AUTHOR), Burton, Christopher (AUTHOR), Weigel, Angelika (AUTHOR), Levenson, James L (AUTHOR), Henningsen, Peter (AUTHOR)
Source: Lancet. Jun2024, Vol. 403 Issue 10444, p2649-2662. 14p.
Subjects: Life change events, Psychotherapy, Psychosocial factors, Somatization disorder, Symptoms, Drug therapy, Communicative disorders
Abstract: 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. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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DbLabel: Psychology and Behavioral Sciences Collection
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  Data: Persistent physical symptoms: definition, genesis, and management.
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  Data: <searchLink fieldCode="AR" term="%22Löwe%2C+Bernd%22">Löwe, Bernd</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Toussaint%2C+Anne%22">Toussaint, Anne</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rosmalen%2C+Judith+G+M%22">Rosmalen, Judith G M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Huang%2C+Wei-Lieh%22">Huang, Wei-Lieh</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burton%2C+Christopher%22">Burton, Christopher</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Weigel%2C+Angelika%22">Weigel, Angelika</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Levenson%2C+James+L%22">Levenson, James L</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Henningsen%2C+Peter%22">Henningsen, Peter</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. Jun2024, Vol. 403 Issue 10444, p2649-2662. 14p.
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  Data: <searchLink fieldCode="DE" term="%22Life+change+events%22">Life change events</searchLink><br /><searchLink fieldCode="DE" term="%22Psychotherapy%22">Psychotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink><br /><searchLink fieldCode="DE" term="%22Somatization+disorder%22">Somatization disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+therapy%22">Drug therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Communicative+disorders%22">Communicative disorders</searchLink>
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  Data: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=177871466
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              Text: Jun2024
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