The role of somatoform disorders in case of aseptic inflammations observed during the Familial Mediterranean fever (FMF)

Background

Till the present it has been disputable if somatoform disturbances cause aseptic inflammations, or visa versa, with patients suffering from FMF.

Our previous investigations [1, 2] showed that FMF should be classified as a psychosomatic disorder. But a question arises: Are the psychic disorders which precede aseptic inflammation not connected with psychosomatics disorders?

Materials and methods

To answer the above-mentioned question, clinical- psychopathological, experimental psychological, neurological (EEG, Echo-EEG, neurooftalmological) and therapeutic multidiscipline investigations were made among 35 patients (24 men, 6 women 6–30 years old).

The duration of catamnstic observetion: 5–20 years.

Results

The results of our investigations showed that 1–2 years before the appearance of aseptic inflammations, changes were observed in the psychic world of the patient, in different organ-systems, where in case of absence of somatic diseases they are classified as somatoform disorders. After the genesis of aseptic inflammations, the nature of psychic disorders sharply changes, which is mainly expressed before the attack in the form of senestopathic and senesto-hypochondac phenomena. The mentioned senesto-hypochondrac phenomena are not only situated in the limit of those organs which are included in the aseptic inflammation, but also carry a suffering, unpleasant character. The idea that the last mentioned are not a result of an aseptic inflammation, proves the fact that these inflammatory processes disappear with psychotherapy and treatment with antidepressants and in not rare cases during the change of residence of the patients.

Discussion

Aseptic inflammations can be observed in different stages of the development of FMF- preceding or following the neurotic disorders. They can begin (not conditioned with somatic diseases) neurotic disorders, later passing to somatised (processing with aseptic inflammation) psychic (with senestopathic and senestohypochondriac) disorders.

These disorders often disappear during psychotherapy [3] and application of antidepressants. As the above mentioned disorders, the lasting nature of the disorders (not in rare cases observed) as well witness that the aseptic inflammation, which is considered to be one of the main symptoms of FMF, belongs to the psycho-somatic disorders.