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Background Somatic Symptoms Disorder (SSD) has been shown to have a clinically very high prevalence in Parkinson's Disease (PD) with frequencies ranging from 7.0% to 66.7%, higher than in the general population (10%- 25%). SSD has been associated with dysfunction in Default Mode and Salience network. Aim With the present study we aim to verify by means of resting state functional MRI whether possible specific abnormalities in the activation and functional connectivity of the default mode network (DMN) and salience network in cognitively intact PD patients may be more prominent in PD patients with somatic symptoms (SSD-PD) as compared with patients without SSD (PD). Methods Eighteen SSD-PD patients (61% male), 18 PD patients (83% male) and 22 healthy age-matched subjects (59% male) were enrolled in the study and underwent resting state functional MRI. Results fractional amplitude of low-frequency fluctuation (fALFF) showed reduced activity in bilateral lateral parietal cortex and in left anterior insula in both SSD-PD and PD compared to control group. Functional connectivity (FC) values in the DMN areas and between DMN and salience network areas were found to be lower in SSD-PD than in control group and PD. No significant correlation was found between fMRI results and demographic and clinical variables, excluding the effect of possible confounders on fMRI results. The present study, showing reduced activity in bilateral parietal areas and in the left anterior insula as compared to healthy controls, suggests a dysfunction of the DMN and salience network in PD, either with or without SSD. The FC reduction within DMN areas and between DMN and salience network areas in SSD-PD patients suggests a role of dysfunctional connectivity in the resting state network of patients with SSD., Highlights • Reduced activity in parietal areas and in anterior insula in Parkinson's Disease. • Functional connectivity is lower in Parkinson's disease with somatic symptoms. • Somatic Symptoms in PD are related to default mode and salience network alterations.

Medically Unexplained Physical Symptoms (MUPS) are physical symptoms without a medical explanation. This study collected data from hospitalized patients presenting MUPS, aiming to draw a clinical and socio-demographic profile of patients with MUPS, to explore psychopathological correlations of Somatic Symptoms Disorder (SSD) diagnosis, and to estimate economic costs related to hospital management for MUPS. The cross-sectional study consisted in the evaluation of data referring to hospitalized patients admitted between 2008 and 2018 in a teaching hospital in Northern Italy. A total of 273 patients presenting MUPS have been hospitalized. The sample showed a prevalence of female, married and employed patients. The most frequent wards involved are Neurology, Internal Medicine and Short Unit Stay. The most common symptoms found are headache, pain, syncope and vertigo. There is no evidence that a history of medical disease is associated with a diagnosis of SSD. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for patients with MUPS is 475'409.73 &euro, The study provides the investigation of a large number of patients with MUPS and a financial estimate of related hospitalization costs.

Psychosomatic disorders are among the most common psychiatric disorders in general practice, with a prevalence of 16%. These patients often turn to different general practitioners and/or non-psychiatric specialists for long periods of time and represent a diagnostic and therapeutic challenge, as the possible organic component makes it complex and difficult to manage. The reported case is a 24-year-old male patient with a diagnosis of Somatic Symptoms Disorder and multiple psychiatric comorbidities. The purpose of this study is to review the reconceptualization of Somatoform Disorders’ DSM-5 diagnosis, which can be useful for psychiatrists and non-psychiatric physicians for the approach and management of these patients.

Multiple chemical sensitivity (MCS) is a disorder of unknown etiology with no effective treatment. Many clinicians accept that a diagnosis of somatic symptoms disorder (SSD) is an appropriate diagnostic category for MCS. We found that administration of levetiracetam improved recurrent symptoms of MCS in a patient. A 23-year-old female presented with recurrent multiple symptoms of musculoskeletal, airway or mucous membrane, heart/chest-related, gastrointestinal, cognitive, affective, neuromuscular, head-related, and skin-related induced by exposure to diesel or gas engine exhaust, tobacco smoke, insecticide, gasoline, paint or paint thinner, cleaning products, fragrances, tar or asphalt, nail polish or hairspray, and new furnishings. Gastrointestinal, cognitive, and skin-related symptoms were precipitated by some food additives. She suffered partial seizures from the age of 17 years, and was diagnosed with right parietal lobe epilepsy. Administration of levetiracetam (250 mg/day) eliminated her MCS symptoms. Levetiracetam reduces the release of presynaptic neurotransmitter including glutamate by binding to presynaptic vesicle protein. A recent study established the presence of glutamatergic overactivation in somatization disorder, a form of SSD. Our case may indicate that a subset of patients with SSD have glutamatergic overactivation, which levetiracetam can normalize. J. Med. Invest. 64: 296-298, August, 2017.

Somatic symptom disorder (SSD) often leads to frequent doctor visit not only to psychiatrists but also to various kinds of physicians. We encountered four cases of SSD, particularly associated with sexual intercourse and fear of sexually transmitted diseases (STDs). To best of our knowledge, there is no independent clinical entity assigned to this phenomenon. Here, we propose a variation of SSD called four STD as an independent clinical entity since the presentation of this disorder is very distinctive, and lack of awareness of it may lead to unnecessary laboratory workup and antimicrobial prescription as well as augmented anxiety of the patients with potential "doctor shopping." Further studies are needed to elucidate the pathophysiology, diagnosis, and treatment of this disorder.

The study aimed to study the prevalence of Somatic symptom and related disorders among regular female patients of faith healers. The study was exploratory in nature and case studies of ten females were taken. The study aimed to investigate the prevalence of Somatic symptom and related disorders among those women who regularly visit Faith healers for the cure of all major to minor illnesses and do not trust doctors after nil diagnosis. The cases were taken from Rawalakot and Rawalpindi. Detailed histories and current condition of the patients were obtained. The patients were asked for their symptoms, incidence and onset of symptoms, severity and intensity of symptoms and recurrence. On the basis of which, the patients were diagnosed according to DSM-V (2013) criteria for Somatic symptom and related disorders cluster. The results showed that 7 out 10 women were suffering from some type of somatic symptom and related disorders. The patients needed to seek psychological help but they weren"t aware of this fact. All of the patients turned to faith healers because doctors provided nil diagnosis as their bodily symptoms were purely psychological. Link: http://aeirc-edu.com/ojs14/index.php/app/article/view/220/395