This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is consi...This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.展开更多
With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“th...With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom.Modelling and simulation have a long history in science to gain insight also into complex phenomena.Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research.Calculation models have to fit to the complexity of this disorder category.In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is elaborated.Starting from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research.How psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.展开更多
文摘This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.
文摘With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is stimulated.By turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the symptom.Modelling and simulation have a long history in science to gain insight also into complex phenomena.Considering the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process research.Calculation models have to fit to the complexity of this disorder category.In an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is elaborated.Starting from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process research.How psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.
