Somatic symptom disorder
A somatoform disorder[1] is the manifestation of psychological conflict in physical form, which can include paralysis, blindness and physical pain. Some patients may show an impairment or complete loss of a physiological function, without a medically explainable cause. Everyone experiences these types of aches and pains, but they become pathological only when an individual experiences significant distress or impairment in their life. These physical symptoms are not a result of malingering, and are often encountered in medical settings.
Classification
The following disorders are recognized by the DSM-IV-TR:
- Body dysmorphic disorder is a preoccupation with an imaginary or wildly exaggerated defect in physical appearance.
- Hypochondriasis is a well known somatoform disorder, in which the patient worries excessively about his or her health. Hypochondriacs misinterpret their symptoms as signs of a serious illness and usually present to a physician already having determined a diagnosis. These fears are irrational because they persist despite medical evidence to the contrary, but not delusional since the feared illness is usually an ordinary syndrome, such as coronary heart disease or cancer
- Somatization disorder is a pattern of numerous and repeated physical complaints that begin by age 30, persist for several years, and causes the person to seek medical treatment but cannot be medically explained. A diagnosis requires a specific combination of pain, gastrointestinal, sexual and neurological symptoms.
- Undifferentiated somatoform disorder is a diagnosis for unexplained physical complaints that last for at least six months, but do not meet the diagnostic threshold for somatization disorder.
- Pain disorder is characterized by pain that is seen as the disorder itself, not as a symptom. Even when a medical condition exists, the pain seems to be more severe than can be explained by a physical cause, psychological factors are assumed to play a role.
- Conversion disorder is an actual disability that mimics a neurological or medical condition, yet cannot be explained by an organic cause. The most common conversion symptoms are blindness, deafness, paralysis, and anesthesia.
- Somatoform disorder not otherwise specified is a diagnosis for individuals who present with somatoform symptoms but do not meet the criteria for any of the somatoform disorders.
Treatment
Cognitive behavioral treatment is best according to a systematic reviews of randomized controlled trials.[2][3]
Reassurance may help according to a randomized controlled trial.[4]
Frequent visits, perhaps monthly, with their primary care physician may reduce may reduce health expenditures according to a randomized controlled trial.[5]
Primary care physicians can treat somatization.[6]
References
- ↑ The world soma means "body", thus, these disorders pertain to the body.
- ↑ Sumathipala A (2007). "What is the evidence for the efficacy of treatments for somatoform disorders? A critical review of previous intervention studies". Psychosom Med 69 (9): 889–900. DOI:10.1097/PSY.0b013e31815b5cf6. PMID 18040100. Research Blogging.
- ↑ Kroenke K (2007). "Efficacy of treatment for somatoform disorders: a review of randomized controlled trials". Psychosom Med 69 (9): 881–8. DOI:10.1097/PSY.0b013e31815b00c4. PMID 18040099. Research Blogging.
- ↑ van Bokhoven MA, Koch H, van der Weijden T, et al (2009). "Influence of watchful waiting on satisfaction and anxiety among patients seeking care for unexplained complaints". Ann Fam Med 7 (2): 112–20. DOI:10.1370/afm.958. PMID 19273865. Research Blogging.
- ↑ Smith GR, Monson RA, Ray DC (1986). "Psychiatric consultation in somatization disorder. A randomized controlled study.". N Engl J Med 314 (22): 1407-13. PMID 3084975.
- ↑ Smith RC, Gardiner JC, Luo Z, Schooley S, Lamerato L, Rost K (2009). "Primary care physicians treat somatization.". J Gen Intern Med 24 (7): 829-32. DOI:10.1007/s11606-009-0992-y. PMID 19408058. PMC PMC2695533. Research Blogging.