Symptoms of Somatoform Disorders

Complaints about physical symptoms in the absence of medical evidence.

The problem is very real in the mind, though not the body.

usual numerous, constantly evolving complaints such as chronic pain, upset stomach, dizziness.

Worry about a deadly disease despite negative medical evidence.

Diagnosis of Somatoform Disorders

Conversion Disorder is where symptoms mimic neurological disorders. The symptoms make no anatomic sense. This lack of physical evidence implies that psychological conflicts are being converted into physical symptoms

Individuals with somatization disorder usually have a history of multiple somatic complaints in the absence of organic impairments. The onset for this disorder is usually prior to age 30.

Hypochondriasis is the fear or belief that one is suffering from a physical illness. These fears are much more serious than normal or fleeting worries and can lead to substantial impairment in life functioning.

Pain disorder is a preoccupation with pain. Such individuals are at risk for developing dependence on pain medication.

Individuals with body dysmorphic disorder tend to have a preoccupation with some imagined defect in appearance. They have repeated visits to the plastic surgeon. It’s their second home. Again, these concerns exceed normal worry about imperfections

Individuals with malingering and factitious disorder pretend to have a physical illness in order to achieve some external gain, such as money or attention. Factitious disorder is motivated by a desire to assume a sick role

Freqency of Somatoform Disorders

Somatoform disorders are 10 times more common among women. They are more common among individuals in lower socio-economic classes. They are four times more common among African Americans and even higher in Perto Rico and Latin America

Comorbidity

Depression, anxiety, and antisocial personality disorder all commonly overlap somatoform disorders.

Causes of Somatoform Disorders

Biological Factors

Current Reality Tree showing diagnosis of mult...

Diagnosis usually accomplished by exclusion of physical factors. This is a dangerous route though because sometimes you may discover years later that there was in fact a physical problem, but it wasn’t detected. The picture above shows the problems of this method. Even though it’s a car stereo example, the same concepts still apply.

Psychological Factors

Primary and secondary gain

Cognitive tendencies: amplification, alexithymia

Treatment of Somatoform Disorders

Operant approaches to chronic pain are sometimes used. The individual is rewarded for successful coping and adaptation.

Cognitive behavioral therapy aims to restructure the thoughts that a person has.

Antidepressants are sometimes used as well.

Patients are likely to refuse a referral to a mental health professional.

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