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The most common
characteristic of the somatoform disorder is the appearance of
physical symptoms or complaints for which they have no organic
basis. Such dysfunctional symptoms tend to range from sensory
or motor disability, hypersensitivity to pain. Four major somatoform
disorders exist: conversion disorder (also known as hysteria),
hypochondriasis, somatization disorder, and somatoform pain disorder.
Somatization disorder is also known as Briquet's Syndrome.
Starting before
age thirty, the patient has had many physical complaints occurring
over several years and has sought treatment for these symptoms,
or they have materially impaired social, work or personal functioning.
The patient has at some time experienced a total of at least 8
symptoms from the following list for which the symptoms need not
be concurrent.
PAIN SYMPTOMS (4 or more) related to different sites, such as
head, abdomen, back, joints, extremities, chest or rectum, or
related to body functions such as menstruation, sexual intercourse
or urination.
GASTROINTESTINAL
SYMPTOMS (2 or more, excluding pain) such as nausea, bloating,
vomiting (not during pregnancy), diarrhea, intolerance of several
foods.
SEXUAL SYMPTOMS
(at least 1, excluding pain) including indifference to sex, difficulties
with erection or ejaculation, irregular menses, excessive menstrual
bleeding or vomiting throughout all nine months of pregnancy.
PSEUDONEUROLOGICAL
SYMPTOMS (at least 1) including impaired balance or coordination,
weak or paralyzed muscles, lump in throat or trouble swallowing,
loss of voice, retention of urine, hallucinations, numbness (to
touch or pain), double vision, blindness, deafness, seizures,
amnesia or other dissociative symptoms, loss of consciousness
(other than with fainting). None of these is limited to
pain.
For each
of the above symptoms, one of these conditions must be met:
Physical or laboratory investigation determines that the symptom
cannot be fully explained by a general medical condition
or by substance use, including medications and drugs of abuse,
or
If the patient does have a general medical condition, the impairment
or complaints exceed what you would expect, based on history,
laboratory findings or physical examination.
The patient doesn't consciously feign the symptoms for material
gain (Malingering) or to occupy
the sick role (Factitious Disorder).
Symptoms:
Vomiting.
Abdominal Pain.
Nausea.
Bloating.
Diarrhea.
Pain in the arms or legs.
Back Pain.
Joint pain.
Pain during urination.
Headaches.
Shortness of breath.
Palpitations.
Chest Pain.
Dizziness.
Amnesia.
Difficulty swallowing.
Vision changes.
Paralysis or muscle weakness.
Sexual apathy
Pain during intercourse
Impotence
painful menstruation
Irregular menses
Excessive menstrual bleeding
Discussion of other aspects of life may cause anxiety
Note: A variety of symptoms may be present at any given
time.
Associated
Features:
Many somatic
complaints and long, complicated medical histories.
Psychological distress and interpersonal problems are prominent>
Medical histories are often circumstantial, vague, imprecise,
inconsistent and disorganized.
Differential
Diagnosis:
Some disorders
have similar or even the same symptoms. The clinician, therefore,
in his/her diagnostic attempt, has to differentiate against the
following disorders which need to be ruled out to establish a
precise diagnosis.
None psychiatric
medical conditions that may explain the symptoms.
Causes:
The cause
is not specific but symptoms begin or worsen after losses (for
example, job, close relative, or friend). A greater intensity
of symptoms often occurs with stress.
Treatment:
The goal of
treatment is to help the person learn to control the symptoms.
A supportive
relationship with a sympathetic health care provider is the most
important aspect of treatment. Regularly scheduled appointments
should be maintained to review symptoms and the person's coping
mechanisms.
Acknowledgment and explanation of test results should occur. It
is not helpful to tell the people with this disorder that their
symptoms are imaginary. People with a somatization disorder rarely
acknowledge that their illness has a psychological component and
will usually reject psychiatric treatment.
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None
Somatization
Disorder's
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