Immune-inflammatory Pathways in Somatoform-Disorders : A Theoretical Update

Abstract

Somatoform disorders are comprised of conditions where patients have multiple somatic symptoms without any underlying medical explanation for the causation of such symptoms and cause significant psychosocial distress. These somatic complaints often occur in major depression and chronic fatigue syndrome where involvement of immune-inflammatory pathways has been described, which suggests their possible involvement in somatoform disorders. This stimulated research and lead to unravelling the possible role of mechanistic pathways like cell-mediated immunity and subsequent inflammation, the involvement of TRYCAT (tryptophan catabolite), and oxidative/nitrosative stress pathways in somatoform disorders. In this review, we attempt to provide an overview of the three possible pathways elucidated to date as a precise understanding of the biological underpinnings has profound implications in stimulating further research in these poorly understood group of disorders.