On January 29, at the information sharing session about the little-known disease “body dysmorphic disorder”, Dr. Trinh Thi Van Anh, Department of Stress-Related Disorders and Sexual and Gender Health (Institute of Health) Mental Health – Bach Mai Hospital) said that recently, the hospital had just treated a female patient with body dysmorphic disorder.
I went everywhere and couldn’t find the disease
The patient is Ms. Trinh Minh H. Female (54 years old, residing in Bac Giang), admitted to the hospital after a long period of burning in the epigastric and chest areas, nervousness, a lot of pain when eating and drinking, weight loss, and frequent defecation. times a day.
Taking the history, it was revealed that the patient had a harmonious family, a gentle husband, obedient children, and good education. However, the patient often has tension with her mother-in-law over the smallest things, but occasionally there are conflicts between mother-in-law and daughter-in-law.
Patients often complain of burning chest pain even though they go to many doctors and see no evidence of the disease. Illustration woodlandsheartinstitute
The disease has been progressing for about 2 years now. The patient initially had poor sleep, had difficulty falling asleep, did not sleep deeply, and often woke up early (around 4 a.m.) and could not go back to sleep.
Then the patient has a burning sensation in the epigastric area, sometimes the burning feeling spreads to the entire abdomen, spreading to the back, accompanied by pain in the epigastric area, the feeling of food refluxing into the throat. Patients often have more pain when eating and drinking, defecating many times a day, eating or straining and defecating (sometimes 5-7 times a day).
Therefore, the patient gradually became afraid of eating and drinking, losing about 7kg/6 months. The patient went to the provincial hospital for examination, had a gastroesophageal endoscopy, was diagnosed with gastritis – esophageal reflux, and took medication as prescribed.
At first, the patient felt better and felt more comfortable, but after half a month the patient had the burning sensation and difficulty defecating as above, and sometimes the symptoms became more severe.
Six months ago, the patient had a burning feeling in the chest area, nervousness, palpitations, even when the patient was resting, he still felt his heart beating strongly. When he could not sleep or was emotional, the above feeling increased.
Patients sometimes feel hot, flushed, and easily irritable. The patient has poor sleep at night and has difficulty falling asleep. After that, the patient went to Hanoi Medical University Hospital for examination, was diagnosed with a mixed anxiety and depression disorder and was prescribed medication.
Patients feel better, reduce burning in the abdomen and chest, reduce anxiety, and can sleep. The patient was treated with prescription medication for 4 months and felt almost cured, so he quit the medication and did not go to the doctor again. Two weeks later, the patient’s symptoms recurred: burning stomach, chest pain, nervousness, insomnia, and a lot of discomfort.
The patient went to the Institute of Mental Health for examination, was diagnosed with somatoform disorder, and was hospitalized for inpatient treatment.
After a period of treatment, patients can sleep better and complain less about physical symptoms.
Perfectionists are susceptible to somatization disorder
Dr. Duong Minh Tam, Head of the Department of Treatment of Stress-Related Disorders and Sexual Health (Institute of Mental Health), said that people with somatoform disorders often complain about the symptoms repeatedly. body, along with persistent requests for medical examination, despite repeated negative results and physician assurances that these symptoms had no physical basis.
Dr. Duong Minh Tam said that patients with somatoform disorders tend to go to the doctor everywhere even though the doctor says “there is no disease”. (Dr. Duong Minh Tam shared on January 29. Photo of collaborator)
Or if there are any physical disorders, they do not explain the nature and extent of the symptoms or the patient’s suffering and preoccupation with the trivialities of daily life.
Patients also have a detail-oriented, perfectionistic personality and weak resistance to conflicts and collisions.
Symptoms of the disease are often random pain throughout the body such as headache, dizziness, lightheadedness, blurred vision, shoulder and neck pain or symptoms of chest pain, palpitations, difficulty breathing like symptoms of heart and lung disease. There are also patients with abdominal pain such as gastric reflux, colon pain, bloating, unstable bowel movements…
Patients may also have pain or experience unpleasant symptoms in the genitourinary – urinary tract, nerves – muscles…
“This is a difficult disease to diagnose. Many patients have to knock on the doors of many hospitals to find the cause of their pain and discomfort but still cannot find it. There are many patients who come for examination with a stack of medical records. “I’ve been to dozens of hospitals, done hundreds of tests, and been treated for all kinds of diseases, but the pain still doesn’t relieve me,” Dr. Tam shared.
According to Dr. Tam, to diagnose the disease, we can refer to signs such as at least two years of various and changing physical symptoms without finding a satisfactory physical explanation; Persistent refusal to accept doctor’s advice or reassurance that there is no physical illness.
People who are perfectionists and pay attention to details are more likely to suffer from body dysmorphic disorder. Illustration of ananda
Patients always tend to go to the hospital to resolve all their discomforts, so they often go for examination and treatment everywhere.
According to Dr. Tam, body dysmorphic disorder is a chronic disease, the disease process lasts many years and is often resistant to treatment. If detected late, treatment is not timely, the patient goes to many specialists, causing economic costs, which can lead to anxiety and depression.
In addition, not treating for enough time and not following the treatment plan increases the risk of treatment resistance. If left for a long time, the patient may abuse anxiolytic drugs such as seduxen…
“To treat somatization disorder, one only needs a reasonable explanation of the symptoms of the disease and cognitive behavioral therapy for the patient. At the same time, combine it with relaxation training to treat and prevent the disease. Depending on the patient’s situation, the doctor can prescribe appropriate medication,” Dr. Duong Minh Tam