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.