In psychology, a somatoform disorder is a mental disorder characterized by physical symptoms that suggest physical illness or injury – symptoms that cannot be explained fully by a general medical condition, direct effect of a substance, or attributable to another mental disorder (e.g. panic disorder). The symptoms that result from a somatoform disorder are due to mental factors. In people who have a somatoform disorder, medical test results are either normal or do not explain the person’s symptoms. Patients with this disorder often become worried about their health because the doctors are unable to find a cause for their health problems. Symptoms are sometimes similar to those of other illnesses and may last for several years.
Somatoform disorders are not the result of conscious malingering (fabricating or exaggerating symptoms for secondary motives) or factitious disorders (deliberately producing, feigning, or exaggerating symptoms) – sufferers perceive their plight as real. Additionally, a somatoform disorder should not be confused with the more specific diagnosis of a somatization disorder.
Disorders in this Category
- Body Dysmorphic Disorder
- Conversion Disorder
- Hypochondriasis Disorder
- Pain Disorder
- Somatization Disorder
Body dysmorphic disorder (BDD) (previously known as dysmorphophobia is sometimes referred to as body dysmorphia or dysmorphic syndrome) is a (psychological) somatoform disorder in which the affected person is excessively concerned about and preoccupied by a perceived defect in his or her physical features (body image).
The sufferer may complain of several specific features or a single feature, or a vague feature or general appearance, causing psychological distress that impairs occupational and/or social functioning, sometimes to the point of severe depression and anxiety, development of other anxiety disorders, social withdrawal or complete social isolation, and more. It is estimated that 1–2% of the world’s population meet all the diagnostic criteria for BDD (Psychological Medicine, vol. 36, p. 877).
The exact cause(s) of BDD differ(s) from person to person. However, most clinicians believe it could be a combination of biological,psychological, and environmental factors from their past or present. Abuse and neglect can also be contributing factors.
Onset of symptoms generally occurs in adolescence or early adulthood, where most personal criticism of one’s own appearance usually begins, although cases of BDD onset in children and older adults are not unknown. BDD is often misunderstood to affect mostly women, but research shows that it affects men and women equally.
The disorder is linked to significantly diminished quality of life and can be co-morbid with major depressive disorder and social phobia, also known as chronic social anxiety. With a completed-suicide rate more than double that of major depression (three to four times that of manic depression) and a suicidal ideation rate of around 80%, extreme cases of BDD linked with dissociation can be considered a risk factor for suicide; however, many cases of BDD are treated with medication and counseling.
A person with the disorder may be treated with psychotherapy, medication, or both. Research has shown cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors(SSRIs) to be effective in treating BDD.
BDD is a chronic illness, and symptoms are likely to persist, or worsen, if left untreated.Learn More
Conversion disorder is a condition in which patients present with neurological symptoms such as numbness, blindness, paralysis, or fitswithout a neurological cause. It is thought that these problems arise in response to difficulties in the patient’s life, and conversion is considered a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV). Formerly known as “hysteria”, the disorder has arguably been known for millennia, though it came to greatest prominence at the end of the 19th century, when the neurologists Jean-Martin Charcot and Sigmund Freud and psychiatrist Pierre Janet focused their studies on the subject. The term “conversion” has its origins in Freud’s doctrine that anxiety is “converted” into physical symptoms. Though previously thought to have vanished from the west in the 20th century, some research has suggested it is as common as ever.
DSM-IV defines conversion disorder as follows:
- One or more symptoms or deficits are present that affect voluntary motor or sensory function suggestive of a neurologic or other general medical condition.
- Psychological factors are judged, in the clinician’s belief, to be associated with the symptom or deficit because conflicts or other stressors precede the initiation or exacerbation of the symptom or deficit. A diagnosis where the stressor precedes the onset of symptoms by up to 15 years is not unusual.
- The symptom or deficit is not intentionally produced or feigned (as in factitious disorder or malingering).
- The symptom or deficit, after appropriate investigation, cannot be explained fully by a general medical condition, the direct effects of a substance, or as a culturally sanctioned behavior or experience.
- The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.
- The symptom or deficit is not limited to pain or sexual dysfunction, does not occur exclusively during the course of somatization disorder, and is not better accounted for by anothermental disorder.
Pain disorder is when a patient experiences chronic pain in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may begin at any age, and more women than men seem to experience it. This disorder often occurs after an accident or during an illness that has caused pain, which then takes on a ‘life’ of its own.Learn More
Somatization disorder (also Briquet’s disorder or, in antiquity, hysteria) is a psychiatric diagnosis applied to patients who persistently complain of varied physical symptoms that have no identifiable physical origin. The disorder must begin before the patient turns 30 years of age and could last for several years, resulting to either medical seeking behavior or significant treatment. One common generaletiological explanation is that internal psychological conflicts are unconsciously expressed as physical signs. Patients with somatization disorder will typically visit many doctors in pursuit of effective treatment.
Examples of manifestations of Pychosomatic disorder are as such: a child itches in response to family issues, and experiencing repressed anger and/or fear. Thus, The child grows and wakes up itching in the same locations, though not aware of the repressed memory causing the suffering in later life, or the patient is engaged in seeking psychotherapy for somatization.
Somatization disorder is a somatoform disorder. The DSM-IV establishes the following five criteria for the diagnosis of this disorder:
- a history of somatic symptoms prior to the age of 30
- pain in at least four different sites on the body
- two gastrointestinal problems other than pain such as vomiting or diarrhea
- one sexual symptom such as lack of interest or erectile dysfunction
- one pseudoneurological symptom similar to those seen in Conversion disorder such as fainting or blindness.