신체증상장애의 약물치료

Pharmacological treatment of somatic symptom disorder

Somatic symptoms are common and cause significant functional impairments. Cognitive Behavioral therapy has the strongest evidence in the efficacy for somatic symptom disorder among psy-chosocial treatments. Meanwhile, there have been a few pharmacological studies for somatic symptom disorder. This review aims to provide the practical principles and overview of pharmacotherapy for somatic symptom disorder. The best therapeutic approach is stepped and multidisciplinary care with close cooperation of mental health, medical, physical professionals on the basis of a biopsychosocial model of illness. Psychotropic drugs including the antidepressants, anticonvulsants, and antipsychotics have been applied in the treatment of somatic symptom disorder. Different classes of antidepressants such as selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and tricyclic antidepressants demonstrated greater improvement compared with placebo in several randomized, placebo-controlled studies. In contrast, although few open trials and case series have reported positive results, there has been no randomized placebo-controlled study for both anticonvulsants and antipsychotics in the treatment of somatic symptom disorder. Future collaborative researches with medical and physical specialist contribute to improving knowledge on the relationship of somatic symptom disorder and functional somatic syndromes and comparing the efficacy of pharmacotherapy, psychosocial interventions, and combination treatments in the treatment of somatic symptom disorder.