“I was plagued by abdominal pain for years, but not for an instant did I think it could be a psychological issue,” said the 30-odd Ms. Lin (pseudonym), whose decade-long abdominal pain was finally alleviated thanks to the joint intervention of the Department of Gastroenterology and the Department of Psychological Medicine at PUMCH. Early this year, PUMCH added a new MDT for Bodily Distress Disorder (BDD) / Somatic Symptom Disorder (SSD), led by the Department of Psychological Medicine working in collaboration with other PUMCH departments such as Neurology, Gastroenterology, Rheumatology, Obstetrics and Gynecology, Otolaryngology and Urology. The new MDT aims at removing the invisible “spells” for patients with BDD / SSD who have symptoms but do not show the corresponding organic lesions.

Jiang Yi’nan, co-initiator of the MDT for BDD / SSD and attending physician of the Department of Psychological Medicine, explains the rationale for setting up the new MDT: according to incomplete statistics, for 20%-30% of patients in outpatient clinics, the chief complaint is physical pain, but physical diseases are not spotted by examinations and tests or the diseases spotted do not seem to be grave enough to cause the somatic symptoms that the patients complain of. Conventional treatments do not work well for such patients. Instead, a multi-pronged approach that involves the intervention by physicians from psychology-related departments is needed to achieve better outcomes. For this reason, the MDT for BDD / SSD was created.

Ms. Lin has had symptoms of abdominal pain since more than ten years ago without organic lesions, and the pain kept recurring even after symptomatic treatment. Having tried her luck at other hospitals, she pinned her hopes on the Department of Gastroenterology at PUMCH, but again, no cause was found, and the doctor proposed a consultation. As part of the consultation, initial evaluation by the Department of Psychological Medicine revealed no tendency of anxiety or depressive disorder. In the subsequent in-depth communication, Ms. Lin divulged that she felt stressed from her family’s high expectations on her academic performance and that she did not land a good job after graduation but was afraid to talk to her family about it, and over time, her abdominal pain intensified. Based on this knowledge, the MDT used medication to improve her sleep and psychological intervention to relieve her stress. Ms. Lin’s symptoms have now greatly improved.

“I think the color of pain is blue and its temperature is cold ...” This is how a patient described his or her somatic symptom by association under the guidance of doctors in the MDT for BDD / SSD. The pain is classified as mild, moderate or severe, and interventions will be administered accordingly. The MDT also uses assessment tools to conduct psychiatric and psychological diagnosis and concurrently treats co-morbidities such as anxiety and depression. “On top of alleviating BDD / SSD and providing psychological intervention, health education is also an important task for the following purposes: first, make patients feel understood and allow them to vent; second, help patients attribute their symptoms to the right causes and see through the symptoms; third, steer patients to properly respond to their body’s reaction, not with the purpose of eliminating it but managing it for higher life quality.” Jiang Yi’nan reminds that when plagued by recurrent or persistent somatic symptoms with no specific disease to account for them, one must consider the possibility of BDD / SSD.

Written by Wang Jingxia

Reviewed by Hong Xia

Translated by Liu Haiyan

Edited by Wang Jingxia, Geng Wenqi and Wang Yao