Shahini Najmeh, Mirzadeh Mansoureh, Lashkarbolouk Narges
Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgan, Iran.
Department of Psychiatry, Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran.
SAGE Open Med Case Rep. 2023 Jun 6;11:2050313X231179304. doi: 10.1177/2050313X231179304. eCollection 2023.
Physical symptoms with normal clinical examinations have been reported without detectable structural or biochemical abnormalities in the comorbidity of somatic symptom disorder and major depressive disorder. This association can have a debilitating effect on their academic and social performance. This case report is about a 13-year-old Afghani immigrant boy with no previous psychiatric history who developed severe body pain leading to a disability during the COVID-19 lockdown and social isolation. During further evaluation, all his clinical examinations were normal, and the diagnosis of major depressive disorder and somatic symptom disorder was confirmed. Cognitive behavioral therapy includes cognitive therapy, changing lifestyle, and a motivational support method. Medical treatment with olanzapine, fluvoxamine, and gabapentin was started. During follow-up, there was improvement in the patient's mood, and the patient began to walk and communicate. It is important to suspect an association of somatic symptom disorder and major depressive disorder in patients with severe body pain and multiemotional factors. Psychiatrists should keep in mind that emotional factors can play a significant role in causing and maintaining physical symptoms.
在躯体症状障碍和重度抑郁症的共病中,有报告称患者存在身体症状,但临床检查正常,未检测到结构或生化异常。这种关联会对他们的学业和社交表现产生削弱作用。本病例报告讲述的是一名13岁的阿富汗移民男孩,他此前没有精神病史,在新冠疫情封锁和社会隔离期间出现了严重的身体疼痛,导致残疾。在进一步评估中,他所有的临床检查均正常,并确诊为重度抑郁症和躯体症状障碍。认知行为疗法包括认知疗法、改变生活方式和一种激励支持方法。开始使用奥氮平、氟伏沙明和加巴喷丁进行药物治疗。在随访期间,患者的情绪有所改善,开始能够行走和交流。对于有严重身体疼痛和多种情绪因素的患者,怀疑躯体症状障碍和重度抑郁症的关联很重要。精神科医生应牢记,情绪因素在引发和维持身体症状方面可能起重要作用。