Zusammenfassung
Somatoforme Störungen zählen zu den häufigsten psychischen Störungen in der Allgemeinbevölkerung. In einer epidemiologischen Perspektive sind generell höhere Prävalenzraten bei Frauen festzuhalten. Die Geschlechtsunterschiede stellen sich allerdings in den einzelnen diagnostischen Kategorien variabel dar. Da Somatisierung in ätiopathogenetischer Hinsicht von vielfältigen Faktoren beeinflusst wird, sind einfache Erklärungen für Geschlechtsunterschiede sehr unwahrscheinlich. Unterschiede in der Wahrnehmung, Interpretation und Kommunikation von Körperreizen, in der Toleranz von Schmerzsensationen, in der Entwicklung von Krankheits- und Gesundheitskonzepten sowie der Sozialisation des Krankheitsverhaltens, in der Assoziation zu Angst- und affektiven Störungen, in der Rate von schwerwiegenden Traumatisierungen und komplexen posttraumatischen Entwicklungen werden als mögliche Faktoren diskutiert, die Einfluss auf die empirisch gefundenen Geschlechtsunterschiede bei Somatisierungssyndromen nehmen könnten. Auf einer klinisch-symptomatologischen Ebene überwiegen die Gemeinsamkeiten eventuelle Unterschiede zwischen Frauen und Männern. In der Diagnostik sind neben allgemeinen Richtlinien spezielle Frauenthemen relevant. Therapeutische Ansätze sind multimodal zu gestalten. Sie unterstreichen zwar allgemein eine grundlegende Bedeutung von "Geschlecht und Sexualität". Hinsichtlich störungsorientierter Verfahren ist in bisherigen Therapiestudien eine geschlechtersensible Dimension aber zu wenig beachtet worden.
Summary
Somatoform disorders are highly frequent in the general population. Women generally show increased epidemiological rates varying, however, among diagnostic categories. Multiple etiological factors play a major role in the process of somatization. Gender-related differences may be discussed in respect of perception, interpretation and communication of bodily stimuli, tolerance of pain sensations, development of illness and health concepts, illness behaviour, association to anxiety and depressive disorders, frequency of serious traumatic experiences and complex posttraumatic reactions. On a level of clinical symptoms communalities overweigh differences between female and male patients. Gender-sensitive issues must be considered beyond general guidelines both in diagnostics and multimodal treatment approaches.
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Kapfhammer, HP. Geschlechtsdifferenzielle Perspektive auf somatoforme Störungen. Psychiatrie 1, 63–74 (2005). https://doi.org/10.1007/s11326-005-0011-9
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DOI: https://doi.org/10.1007/s11326-005-0011-9