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Re: somatoform disorder(s)

Posted by fires on July 23, 2004, at 15:06:27

In reply to Re: somatoform disorder(s) » fires, posted by Larry Hoover on July 23, 2004, at 13:07:02

> > I don't think you attacked me in the near past with ad hominem messages, so I will repond.
> >
> > >>What sets somatoform apart (there are a number of different sub-types, but you don't further specify) is that following a series of diagnostic tests and assessments, no underlying disease state can be found.<<
> >
> > You so eloquently stated above the problem with Somatoform: It assumes that there are tests and assessments currently available for all disorders/diseases. That's an incorrect assumption!!
>
> No, there is no such assumption. Doctors not finding anything that corresponds to their current state of knowledge is not the same thing as assuming they know everything and how to find it.
>
> > Stomach and duodenal ulcers were once considered to be of "psychosomatic" etiology, but along came "better" science, and a bacteria was demonstrated to be the cause of ulcers. So all the ulcer victims were suddenly no longer victims of their own psyches.
>
> Stress is still a factor, and treatment is still symptomatic. Knowing "why to do" is better than knowing "what to do", but apart from adding antibiotic therapy, what to do hasn't changed.
>
> > Perhaps you aren't too familiar with the medical field,
>
> Careful, lest you stray into ad hominem land.
>
> > so I will give you another example of how one can test/be assessed neg. for a med. problem yet still have one/it.
> >
> > My sister (ECG tech) has told me many stories of people who have come into the ER with MI symptoms, only to test negative for MI. Then they die of a massive MI on the way home.
>
> ECG is not 100% sensitive to AMI (false negatives are possible), nor 100% specific for AMI (false positives are possible). Cardiac enzyme levels (myocardial troponin T) are generally very sensitive and specific to ischemia. In any case, anecdote is not really of predictive value. "The exception proves the rule."
>
> >
> >
> > Thank you
> >
> >
>
> You're welcome.

Well. Where to begin? I do believe that you have contradicted yourself.

>>> No, there is no such assumption. Doctors not finding anything that corresponds to their current state of knowledge is not the same thing as assuming they know everything and how to find it.<<

Then why don't they consider that a patient might have such a disorder instead of Dxing Somatoform Disorder?? I had/have such a disorder.
Thank goodness I didn't buy into the Somatoform Dx!!

>>> Stress is still a factor, and treatment is still symptomatic. Knowing "why to do" is better than knowing "what to do", but apart from adding antibiotic therapy, what to do hasn't changed.<<

I will refrain from posting links, but my research indicates that your statement contains errors. 1) Stress *may* be a factor in *some* patients with ulcers. If you have scientific data to the contrary I would like to see it.

2)What to do has changed. Not only are antibiotics given, but Pepto Bismol(sometimes), and the newer PPIs are also used (nearly always) for ulcers.

>>> ECG is not 100% sensitive to AMI (false negatives are possible), nor 100% specific for AMI (false positives are possible). Cardiac enzyme levels (myocardial troponin T) are generally very sensitive and specific to ischemia. In any case, anecdote is not really of predictive value. "The exception proves the rule."<<

Thanks again for so eloquently making my point !! Re-read the above , then apply that same logic to the Dxing of Somatoform. Is there a blood test for Somatoform? or do Pdocs rely on anecdotal and subjective info. to Dx it? "The exception proves the rule"

Thanks


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poster:fires thread:366835
URL: http://www.dr-bob.org/babble/psycho/20040723/msgs/369530.html