Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses, and Medical Uncertainty
by Robert C. Bransfield 1,* and Kenneth J. Friedman 2
1
Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
2
Retired, Plantation, FL, USA. Retired Associate Professor of Pharmacology and Physiology, NJ Medical School, Newark, NJ 07103, USA
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(4), 114; https://doi.org/10.3390/healthcare7040114 (registering DOI)
Received: 15 July 2019 / Revised: 1 October 2019 / Accepted: 1 October 2019 / Published: 8 October 2019

(This article belongs to the Special Issue Lyme Disease and Related Tickborne Infections)
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Abstract
There is often difficulty differentiating between psychosomatic, somatopsychic, multisystem illness, and different degrees of medical uncertainty. Uncommon, complex, and multisystem diseases are commonly misdiagnosed. Two case histories are described, and relevant terms differentiating psychosomatic, somatopsychic, and multisystem illnesses are identified, reviewed, and discussed. Adequate differentiation requires an understanding of the mind/body connection, which includes knowledge of general medicine, psychiatry, and the systems linking the body and the brain. A psychiatric diagnosis cannot be given solely based upon the absence of physical, laboratory, or pathological findings. Medically unexplained symptoms, somatoform disorder, and compensation neurosis are outdated and/or inaccurate terms. The terms subjective, nonspecific, and vague can be used inaccurately. Conversion disorders, functional disorders, psychogenic illness, factitious disorder imposed upon another (Munchausen’s syndrome by proxy), somatic symptom disorder, psychogenic seizures, psychogenic pain, psychogenic fatigue, and delusional parasitosis can be over-diagnosed. Bodily distress disorder and bodily distress syndrome are scientifically unsupported and inaccurate. Many “all in your head” conditions may be related to the microbiome and the immune system. Better education concerning the interface between medicine and psychiatry and the associated diagnostic nomenclature as well as utilizing clinical judgment and thorough assessment, exercising humility, and maintaining our roots in traditional medicine will help to improve diagnostic accuracy and patient trust.
Keywords: psychosomatic; somatopsychic; multisystem illness; medical uncertainty; Lyme disease; Morgellons disease; psychogenic; bodily distress; myalgic encephalitis/chronic fatigue syndrome
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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Bransfield, R.C.; Friedman, K.J. Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses, and Medical Uncertainty. Healthcare 2019, 7, 114.

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