Somatoform Disorders

Somatoform disorders are identified by the presence of physical symptoms for which there are no demonstrable organic findings or known physiological mechanisms and for which there is evidence, or a strong presumption, that the symptoms are linked to psychological factors or conflicts. The DSMIV-TR (APA, 2000) identifies the following categories of somatoform disorders:

Somatization Disorder
Somatization disorder is a chronic syndrome of multiple somatic symptoms that cannot be explained medically and are associated with psychosocial distress and long-term seeking of assistance from health care professionals. Symptoms can represent virtually any organ system but commonly are expressed as neurological, gastrointestinal, psychosexual, or cardiopulmonary disorders. Onset of the disorder is usually in adolescence or early adulthood and is more common in women than in men. The disorder usually runs a fluctuating course, with periods of remission and exacerbation.

Pain Disorder
The essential feature of pain disorder is severe and prolonged pain that causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (APA, 2000). This diagnosis is made when psychological factors have been judged to have a major role in the onset, severity, exacerbation, or maintenance of the pain, even when the physical examination reveals pathology that is associated with the pain.

Hypochondriasis is an unrealistic preoccupation with the fear of having a serious illness. That this fear arises out of an unrealistic interpretation of physical signs and symptoms. Occasionally medical disease may be present, but in the hypochondriacal individual, the symptoms are grossly disproportionate to the degree of pathology. Individuals with hypochondriasis often have a long history of “doctor shopping” and are convinced that they are not receiving the proper care.

Conversion Disorder
Conversion disorder is a loss of or change in body function resulting from a psychological conflict, the physical symptoms of which cannot be explained by any known medical disorder or pathophysiological mechanism. The most common conversion symptoms are those that suggest neurological disease such as paralysis, aphonia, seizures, coordination disturbance, akinesia, dyskinesia, blindness, tunnel vision, anosmia, anesthesia, and paresthesia.

Body Dysmorphic Disorder
This disorder, formerly called dysmorphophobia, is characterized by the exaggerated belief that the body is deformed or defective in some specific way. The most common complaints involve imagined or slight flaws of the face or head, such as thinning hair, acne, wrinkles, scars, vascular markings, facial swelling or asymmetry, or excessive facial hair (APA, 2000).

more on: Predisposing Factors for Somatoform Disorders

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