Doctors

Most specialists will be meeting patients with functional disorders, and therefore it is important that they have knowledge about functional disorders in order to recognise the symptoms.

Prejudice and misconceptions towards this patient group are flourishing, including among some doctors. This is primarily due to a lack of knowledge. The aim of The Research Clinic for Functional Disorders and Psychosomatics is to enable all doctors to recognise patients with functional disorders and to give the same scientific and evidence-based treatment as they give other patients.

Confusion of diagnoses

When doctors meet seriously ill patients with various symptoms, they will initially begin the diagnostic process by considering whether the symptoms fit into any known pattern of illness and by looking for objective changes that fit with an already known diagnosis. The challenge of functional disorders is that patients present many symptoms, but there are no or only a few unspecific, clinical and paraclinical pathological findings. The diagnosis is therefore based on the doctor's recognition of the illness pattern.

Many specialists have developed diagnoses that cover the illness pattern of functional disorders, and some, but far from all, have been diagnosed with one or several of these diagnoses. 

Examples of diagnoses divided according to medical speciality:

  • Rheumatology: Fibromyalgia, Chronic Pain Syndrome
  • Infectious diseases: Chronic Fatigue Syndrome (ME/CFS)
  • Orthopaedics: Whiplash Associated Disorder, reflex dystrophy
  • Environmental medicine: Electricity hypersensitivity, Sick Building Syndrome 
  • Allergy: Multiple Chemical Sensitivity (MCS)
  • Gynaecology: Chronic pelvic pain, premenstrual syndrome
  • Neurology: Pseudo-epileptic seizures, tension headache
  • Gastroenterology: Irritable Bowel Syndrome
  • Psychiatry: Somatisation

These syndrome diagnoses are characterised by very homogeneous symptom patterns based on subjective complaints of symptoms without any diagnostic objective changes. When you examine a patient, the symptoms will not enable you to differentiate between the various diagnoses.

There are many indications that the diagnosis given depends on which specialist the patient is referred to, and which understanding the patient has of his or her symptoms, than on which symptoms the patient presents. Additionally, we see a development of diagnoses both over time and place.

Bodily Distress Syndrome

To avoid this confusion connected to the diagnosis of functional disorders, the diagnosis 'Bodily Distress Syndrome' (BDS) has been developed for scientific research purposes. The diagnosis is prevalent in international research, but it is still not part of the official diagnostic classification systems.

Read more about diagnosing

The GP's role

It is advisable that the GP takes on a co-ordinating role and acts as contact person.

A patient with a functional disorder often needs to be assessed by other specialists. It is therefore important for specialists to be able to recognise the illness pattern of functional disorders.

For patients with functional disorders, there is a significant risk of having to go through numerous physical examinations and sometimes over-medication and invasive procedures if they are not correctly diagnosed. This may in some cases lead to iatrogenic damage and side effects.

 

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Revised 11.07.2016