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Historically incorrect somatization illness eg MS and...?

Messages
73
Im very intrigued by this psychiatric category apparently a residue from Freuds fantasies about patient health issues...Somatization disorders (the updated hysteria).

I understand that before MRI scans became prevalent - MS was regarded as Conversion/Somatization disorder...and even Cancer at one point...

Apparently any illness which is not explained by test results, or has a lot of symptoms confusing the Doctor, is a fair target for a diagnosis of Somatization...and it has taken a change/improvement in technology to shift an incorrect diagnosis...

Has anyone seen any good articles on this floating around, or examples of other illnesses historically mis-diagnosed into this category? Im trying to build up a narrative around this issue shedding a light on it, because it appears that the mistakes of the past are simply ignored and I didnt hear about an apology to the MS sufferers who were stigmatised int he 70s...but what I do see are articles in national newspapers about CFS and fear avoidance...
 

A.B.

Senior Member
Messages
3,780
A good way to find out what was considered psychosomatic is to look through older research papers.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I think this is the second thread on this topic. I think @Bob started the first one?

There are lists of older diseases counted as psychosomatic/hysteria/conversion/somatization. To that you can add every disease we don't understand yet .... which includes probably thousands of genetic disorders.I compiled a least of at least twenty a few years back but I have no idea what happened to it. It would not surprise me if for old illness alone it approaches a hundred, and adding in newly discovered and as yet undiscovered illness it could be thousands.

All cancer was once considered psychosomatic, but especially breast cancer.
 

A.B.

Senior Member
Messages
3,780
There are lists of older diseases counted as psychosomatic/hysteria/conversion/somatization. To that you can add every disease we don't understand yet .... which includes probably thousands of genetic disorders.I compiled a least of at least twenty a few years back but I have no idea what happened to it. It would not surprise me if for old illness alone it approaches a hundred, and adding in newly discovered and as yet undiscovered illness it could be thousands.

My impression from reading some older material is that almost every disease was believed to have psychosomatic aspects. If onset of the disease was preceded by stress or if the patient had emotional symptoms it was considered a sign that psychosomatic mechanisms were playing a role in this case.
 
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Messages
73
I remember reading some old psychoanalytic paper on rheumatoid arthritis and they were taking about how the joint on the woman's ring finger was affected when she was having marital stress.

lol

but especially breast cancer.

I guess this is because woman are all hysterical?

MS and Parkinson's symptoms are still partially psychogenic according to some; see "functional overlay"

misdiagnosed illnesses:

Movement disorders
Graves Disease
Asthma
Diabetes
Cerebral Palsy
Peptic ulcers
Lupus
Tuberculosis
Schizophrenia

http://mpkb.org/home/alternate/psychosomatic

thanks this is a good list
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
I think this is the second thread on this topic. I think @Bob started the first one?
I made a list of alternative names for 'somatisation', if that's what you're thinking of?
http://forums.phoenixrising.me/index.php?threads/psychosomatic-disorders-synonyms.23109/#post-353403

And I included this info:

And here's Wessely and White's delightful paper on the subject of the "functional somatic syndrome":

There is only one functional somatic syndrome
The British Journal of Psychiatry (2004)185: 95-96
doi:10.1192/bjp.185.2.95
http://bjp.rcpsych.org/content/185/2/95.full

And (via Tom Kindlon's Twitter account) here's what UK medical students are currently being taught about functional disorders, including CFS, in the 8th edition (2012) of the Kumar & Clark textbook, "Clinical Medicine":
https://www.inkling.com/read/kumar-...ne-8th/chapter-23/functional-or-psychosomatic
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
There was an attempt to compile a list some years back. I posted some stuff on it. This is in addition to talking about alternative names. Did I get the two discussions confused, I wonder? It was at least a couple of years ago.

It has always been my intention to compile a long detailed list. I just have never gotten around to it.

Currently though I have THREE tests that have been around since the 40s that are useful in ME and CFS, and often show real objective problems:

1. Tilt table test 1940.
2. Quantitative EEG 1946
3 Cardiopulmonary exercise test, CPET, 1949. Revised protocol 2007, the two day CPET.

Those who promote psychogenic views love to say there are no tests showing abnormalities in these patients. For ME we have the above three that frequently show problems, and sometimes show severe problems.

PS I think PET scans date from about 1975.

PPS qEEG is dependent to a large extent on the sophistication of the analysis. Its not clear what year this was sufficient to be useful for ME. It might have been very recent.
 
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barbc56

Senior Member
Messages
3,657
My mother had severe psoriasis and it was considered to have a large psychiatric component. This was back in the 1950s.

It was also thought that where you broke out meant something but I don't remember the particulars. I might not be remembering this correctly.

Also, asthma. I remember my family talking about a cousin who had asthma and how it supposedly disappeared when he joined the army as it "straightened him out".:rolleyes:

Barb
 

worldbackwards

Senior Member
Messages
2,051
And here's Wessely and White's delightful paper on the subject of the "functional somatic syndrome":

There is only one functional somatic syndrome
The British Journal of Psychiatry (2004)185: 95-96
doi:10.1192/bjp.185.2.95
http://bjp.rcpsych.org/content/185/2/95.full
Wessely and White on the same bill! It reminds me of that other great pairing:

iu
 

Snowdrop

Rebel without a biscuit
Messages
2,933
I remember reading some old psychoanalytic paper on rheumatoid arthritis and they were talking about how the joint on the woman's ring finger was affected when she was having marital stress.

And there's still plenty of where that came from.
How is that thinking not embarrassing to science professionals?
Perhaps these guys would like to have a second career as guides on the magical mystery tour.
 

Anne

Senior Member
Messages
295
I understand that before MRI scans became prevalent - MS was regarded as Conversion/Somatization disorder...and even Cancer at one point...

Apparently any illness which is not explained by test results, or has a lot of symptoms confusing the Doctor, is a fair target for a diagnosis of Somatization...and it has taken a change/improvement in technology to shift an incorrect diagnosis...

Has anyone seen any good articles on this floating around, or examples of other illnesses historically mis-diagnosed into this category? Im trying to build up a narrative around this issue shedding a light on it, because it appears that the mistakes of the past are simply ignored and I didnt hear about an apology to the MS sufferers who were stigmatised int he 70s...

Excellent, for years I've been looking for what you describe here - a list and a narrative of all the illnesses which have been mislabeled as psychiatric. Please let us know what you come up with!

Thoughts:

- There should be revealing information in old medical textbooks.

- Stomach ulcers can be added to the list; for a long time considered to be stress-related - science "knew" that no bacteria could survive in the stomach - it was a long, uphill battle for the Nobel-Laureate-to-be who proved that ulcers were in fact caused by H. pylori
 
Messages
73
MS and Parkinson's symptoms are still partially psychogenic according to some; see "functional overlay"

misdiagnosed illnesses:

Movement disorders
Graves Disease
Asthma
Diabetes
Cerebral Palsy
Peptic ulcers
Lupus
Tuberculosis
Schizophrenia

http://mpkb.org/home/alternate/psychosomatic
Excellent, for years I've been looking for what you describe here - a list and a narrative of all the illnesses which have been mislabeled as psychiatric. Please let us know what you come up with!

Thoughts:

- There should be revealing information in old medical textbooks.

- Stomach ulcers can be added to the list; for a long time considered to be stress-related - science "knew" that no bacteria could survive in the stomach - it was a long, uphill battle for the Nobel-Laureate-to-be who proved that ulcers were in fact caused by H. pylori

thanks...well people have been helpful here - Im not sure I have the resources or energy to go very deep but there are some good starters so far...
 

A.B.

Senior Member
Messages
3,780
Franz Alexander spoke of the "holy seven psychosomatic diseases" around 1950. These were idiopathic hypertension, thyrotoxicosis (hyperthyroidism), bronchial asthma, rheumatoid arthritis, peptic ulcer, ulcerative colitis, and neurodermatitis.

Let's see what these are believed to be caused today:

- Idiopathic hypertension: idiopathic means without known cause. My impression is that unhealthy lifestyle is preferred as explanation over psychosomatic factors nowadays.
- Thyrotoxicosis: autoimmune.
- Bronchial asthma: environmental factors such as air pollution and allergens.
- Rheumatoid arthritis: autoimmune.
- Peptic ulcer: infectious.
- Ulcerative colitis: autoimmune.
- Neurodermatitis: cause(s) unknown. Stress is still listed as possible cause so it's still considered psychosomatic in a portion of cases.
 

chipmunk1

Senior Member
Messages
765
while MS is now accepted to be of autoimmune origin early symptoms are is still frequently misdiagnosed sometimes even as conversion disorder.

Patterns of misdiagnosis of multiple sclerosis.
Levin N1, Mor M, Ben-Hur T.
Author information

Abstract
BACKGROUND:
Multiple sclerosis is a chronic demyelinating disease of the central nervous system that presents with variable signs and symptoms. This variability in the clinical presentation may result in misdiagnosis, unnecessary referrals and misleading information to the patients.

OBJECTIVES:
To identify the types of misdiagnoses made on the presentation of MS.

METHODS:
Fifty consecutive MS patients were questioned on their early symptoms, their mental status, the disease course until the diagnosis was confirmed, and the different diagnoses they received.

RESULTS:
The patients had been referred to 2.2 +/- 1.3 specialists before seeing a neurologist, and learned about their disease 3.5 years after the onset of symptoms. Twenty-nine patients (58%) were initially given 41 wrong diagnoses. While the majority of women were misdiagnosed mentally, orthopedic work-up was offered to the men. Misdiagnosis of MS occurred most often in patients who presented with non-specific sensory symptoms that did not conform to a specific neurologic syndrome. The patients emphasized the fact that not knowing worsened their anxiety, whereas receiving the diagnosis enabled them to begin coping with their disease.

CONCLUSIONS:
MS is often overlooked when patients present with non-specific sensory complaints. The difference in type of misdiagnosis between men and women may reflect a gender-dependent bias in the way physicians interpret sensory