[Pathology of functional somatic syndrome].Nihon Rinsho. 2009 Sep; 67(9):1669-75.NR
The core pathological concept of functional somatic syndrome (FSS) is the discrepancy between patients' subjective experience of somatic symptoms and objective explanation by medical evaluation. Based on the discrepancy, the somatic symptoms with medically unexplained origins maintains, prolonged chronically, and grow up to FSS owing to various factors; physiological pathways, mood disturbance such as anxiety or depression, doctor-patient relationship, psychosocial stresses, alexithymia and alexisomia, and lack of support systems. As the pathology becomes more and more complicated, the psychosocial stresses, mood disturbance, and physiological dysfunction become more significant. Thus, the pathology falls into a vicious circle. Patients with FSS have common problems or characteristics, and have several overlapped diagnoses. FSS should be treated from aspects of both the similarity and the difference.