[Differential diagnosis of somatoform disorders in elderly patients]. / Differenzialdiagnose "Somatoforme Störungen" bei Alteren. Wie erklärt sich der Patient seine Beschwerden?

ABSTRACT

The diagnosis of somatoform disorders in elderly patients is frequently difficult due to the presence of a mixture of symptoms related to organic pathological changes, medication side effects and mental processes. For this reason, important indications of somatoform disorders are difficulties in the doctor-patient relationship that result in the patient being convinced that he/she is suffering from an organic disease which the attending physician is not able to detect. In old age, numerous physical and social losses that must be coped with can be the source of emotional difficulties. While making a diagnosis, it is essential to recognize the underlying psychological connections to the physical symptoms of the patient. The goal is to gently and constructively expand the patient's organic explanation to include psychosomatic possibilities, for example within psychosomatic primary health care. To evaluate difficulties in a doctor-patient relationship, participation in Balint seminars can be very helpful.