Somatopsychic Disorder - Specialists and Information

Somatopsychic disorders are disorders related to coping with illness that occur in connection with the following conditions:

cancer
, organ transplants
, dialysis, and
chronic somatic diseases

. The chronic diseases that trigger these disorders can include a wide variety of conditions, such as:

• Vascular diseases (heart attack, stroke)
• Diabetes mellitus
• Chronic skin diseases, or
• Rheumatic diseases

A somatopsychic disorder is typically coded using F-codes in addition to a somatic diagnosis.

Examples of F-codes include:

• F 33 (Recurrent depressive disorder)
• F 34 (Persistent affective disorders)
• F 40–41 (Anxiety disorders) or
• F 42 (Obsessive-Compulsive Disorder)

Chronic illnesses present those affected with a wide range of psychological and social challenges:

• Emotional coping with internal and external threats and the associated feelings
• Uncertainty regarding one’s social role and responsibilities (changes in relationships with family, friends, and work life)
• Medical adaptation, relationships with healthcare staff, new environment during hospitalization, and the impact of treatment
• Self-integrity and well-being should be developed or maintained as much as possible
• A new, altered self-image with an uncertain future regarding the course of the illness must be developed

Through psychotherapy, those affected can cope with the consequences of their physical illness and reduce stress symptoms @ Photographee.eu /AdobeStock

The psychological consequences of a chronic illness may include:

• Narcissistic injury (anxiety, shame, depression): “I (my body) am no longer worth anything”
• Fear of losing relationships (anxiety, depression, feelings of guilt): “I’m losing my job, my friends, my partner”
• Denial (severity of the illness): “It’s not that bad”—dependence on caregivers—“I can manage on my own—I need others”
• Processing anger and disappointment: “Why me?” – “I have to control myself, otherwise I’ll alienate others”

In addition to the limitations caused by their physical illnesses, some patients also go through a grieving process. Others experience mental health disorders as well, particularly:

• Depressive disorders and
• Anxiety disorders (adjustment disorders, reactive depression)

Doctors must distinguish symptoms that are causally attributable to the physical illness from depressive symptoms.

These may include:

• Weight loss
• Insomnia
• Lack of motivation, and 
• Lack of energy

If depressive disorders are the result of an organic illness or treatment, the following measures are prioritized:

• Treatment of the underlying cause
• Psychopharmacological treatment
• Medically Supported Counseling 

If depression is a reaction to the illness (adjustment disorder), the focus is on medical psychotherapy, up to and including specialized psychotherapy.

Depressive disorders that were present before the illness began require, depending on their severity:

• Medical psychotherapy
• Specialized psychotherapy
• Psychopharmacological treatment

If a disorder has multiple causes—for example, if an HIV patient develops central nervous system involvement—medication can provide support.

Patients often abuse substances and medications to escape the physical and emotional effects of the disease (e.g., benzodiazepines).

In these cases, the following measures are recommended:

• Withdrawal and Detoxification Therapy
• Specialized psychotherapy

Therapy may involve support in coping with the illness, e.g., through:

• Information and medical consultations
• Self-help groups
• Social support
• Group therapy with coping skills training
• Supportive psychotherapies

Self-help groups offer important support for somatopsychic disorders @ Framestock /AdobeStock

Coping with a cancer diagnosis serves as an example of a somatopsychic disorder. For those affected and their loved ones, a cancer diagnosis usually represents an existential crisis.

The subjective experience of the illness is characterized by:

• The threat of death
• Uncertainty about the course of the disease
• Loss of organs, body parts, and functions

Invasive treatment measures that, on the one hand, help and heal, but on the other hand, mutilate, poison, irradiate, or burn

Due to the treatment successes achieved in cancer care, the following goals are paramount:

• Helping patients and their families cope with the disease
• Subjective adjustment to reality and the 
• active engagement with it
• Cooperation with professional helpers

In nearly 50 percent of cases of malignant cancer, psychosomatic disorders are also present, manifesting as follows:

• Depression
• Adjustment disorders
• Anxiety disorders and 
• Personality disorders

To date, experts have been unable to identify a “cancer personality.” The aforementioned personality factors are relevant to coping with the disease, willingness to cooperate, and secondary prevention. 

The same guidelines apply to psychotherapeutic treatment as to the treatment of chronic diseases.