Abstract
Functional Disorders are common medical problems both in primary and in secondary health care. The mechanisms that cause symptoms such as primary pain, fatigue, dizziness are still unknown. Various classifications, including ICD-10 or DSM-5, describe these conditions differently, and new proposals are being developed e.g. in ICD-11, RDoC. Many controversies are evoked by lack of unequivocal explanatory theory. The early psychoanalytical concept has been modified by other explanations, such as immunological abnormalities, dysfunction of vegetative system and HPA axis, central sensitization, diverted processes of perception or predictive processes within cognitive homeostasis dysregulation. Insufficient scientific evidence makes therapies unsuccessful and justifies further study. Psychotherapy, pharmacology and complementary medicine are supplemented by new experimental methods of treatment connected with progress in neuroscience. The recently developed non-invasive Transcranial Direct Current Stimulation (tDCS), Transcranial Magnetic Stimulation (TMS) and - neurofeedback (EEG-NF), based on EEG registration, are undergoing tests. Applying complex mathematical algorithms to localized bioelectrical signal sources makes it possible to modulate and reshape connections of neuronal networks within specific cortex areas. This article presents the current state of knowledge concerning functional disorders, highlighting the ways in which different definitions of FD have an impact on approaches to treatment.
Highlights
Functional disorders (FD), referred to as psychosomatic disorders, are frequent clinical problems in general practice
Studies show that nearly 30% of all patient visits in primary or in secondary care are caused by FD [1, 2]
The new proposal of the EURONET-SOMA (European Network to Improve Diagnostic, Treatment and Health Care for Patients with Persistent Somatic Symptoms) concerning corrections to the ICD-11 version is an important voice in the debate regarding the unification of the nomenclature of these disorders
Summary
Functional disorders (FD) are common medical problems both in primary and in secondary health care. Various classifications, including ICD-10 and DSM-5, describe these conditions differently, and new proposals are being developed, e.g., in ICD-11, RDoC. Insufficient scientific evidence makes therapies unsuccessful and justifies further study. Psychotherapy, pharmacotherapy and complementary medicine are supplemented by new experimental methods of treatment connected with progress in neuroscience. The recently developed non-invasive transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and EEG neurofeedback (EEG-NF), based on EEG registration, are undergoing tests. Applying complex mathematical algorithms to localized bioelectrical signal sources makes it possible to modulate and reshape connections of neuronal networks within specific cortex areas. This article presents the current state of knowledge concerning functional disorders, highlighting the ways in which different definitions of FD have an impact on approaches to treatment
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