Somatoform Disorders


What are Somatoform Disorders?

Somatoform Disorders are a range of mental illnesses that produce bodily symptoms. The primary characteristic of such disorders is that an individual is unable to find a cause for the occurrence of these symptoms. It is unfortunate that it’s difficult to establish a connection between the symptoms and the causes. As a result, others may think that they may be faking their discomfort but the experience of pain and distress is very real and often disrupts the individual’s daily life. However, certain people fake the level of intensity in which the symptoms may occur:

  1. Factitious Disorder: When internal gain such as sympathy is the goal that the individual seeks when they fake or exaggerate their symptoms, it is known as a factitious disorder. Under such conditions, the patient is not fully aware of himself/herself. Thus the entire act is put up subconsciously by the individual.
  2. Malingering: The faking and exaggeration of the symptoms is intentional in case of malingering. It is done for external gain such as insurance benefits to avoid punishment, etc.

Somatoform Disorders Criteria

  • No possible explanation for substance abuse, medical condition or psychiatric illness for the symptoms.
  • Symptoms cause distress and disruption in any of the primary area of the patient’s life, i.e., social life or work.
  • The disorder is not fictitious or malingering.

Somatoform Disorders Symptoms

  • Pain in head, abdomen, joints, chest, rectum, etc.
  • Neurological problems
  • Nausea
  • Bloating
  • Vomiting
  • Anxiety disorder
  • Frustration
  • Intolerance towards certain food items
  • Pain during menstruation, sexual intercourse, urination, etc.
  • Stress
  • Excessive menstrual bleeding
  • Erectile or ejaculatory dysfunction
  • Imparted balance
  • Urinary retention
  • Paralysis

Types of Somatoform Disorders

  • Undifferentiated somatoform disorder: The disorder is similar to somatoform disorders where the patient complains of chronic fatigue and digestive problems. The distinct feature that separates this type from other types is that the patient complains of an unexplainable symptom for at least six months. It is most common among children and adolescents. Individuals may also suffer from personality disorders and depression.
  • Pain disorder: The disorder occurs when people experience pain in various parts of the body and is unable to find a possible relation between the pain and its cause. Recurrent abdominal pain is the most common complaints during childhood, the pain tends to reoccur after full recovery and each episode of pain lasts for about three months. In children, there seems to be a strong relation between anxiety and recurrent abdominal pain. Reflex sympathetic dystrophy is a complex regional pain syndrome in which the patient experiences pain that spreads beyond the injury and becomes a regional pain. Autonomic dysfunction, movement problems, edema, etc. are some of the characteristics of this syndrome. It also includes painful swelling, delay in the refilling of the capillary and limitations in functioning.
  • Conversion disorder: A type of somatoform disorder that implies a neurological or general medical condition. The symptoms affect the voluntary and motor sensory function. The disorder is thrice as likely to occur in adolescents and rarely occurs among children below the age of 5 years. Recent family stress and difficulty in adjusting to changes in family situations are in close association with the development of conversion disorders. Its primary characteristics include loss of senses in the form of deafness or blindness. The symptoms are pseudo neurological, i.e., they seem to have neurological causes, but in reality, there are no such underlying factors.
  • Body dysmorphic disorder: It refers to a situation in which the individual obsesses about a real or imaginary physical defect. They may include scars, acne, pimples, blemishes, thinning of hair, excessive facial hair, facial asymmetry, etc. as a cause of increasing levels of distress. Patients usually keep their distress a secret and do not seek help. People suffering from this disorder often seek help from dermatologists or undergo cosmetic surgery to rectify the flaws. The patients may also report childhood maltreatment in the form of physical, sexual and emotional abuse. It may lead to gender identity disorder, narcissistic personality disorder, social phobia, delusional disorder, anorexia nervosa, etc.
  • Hypochondriasis: It is a type of disorder that stems from the misinterpretation of certain symptoms that one may be experiencing on his/her own. It leads them to believe that they are suffering from a serious medical condition in response to the most trivial symptoms. For instance, if a person suffers from frequent headaches, they may think that they have a brain tumor. The anxiety that such misdiagnosis causes results in the development and worsening of the disorder. It results in over evaluation which is a primary characteristic of obsessive-compulsive disorder.

Diagnosis of Somatoform Disorders

If the doctor suspects a patient to be suffering from a somatoform disorder, he/she will conduct a physical examination to rule out other medical conditions as underlying causes of the symptoms. If the patient proves to be physically healthy, the physician makes a thorough evaluation of the patient’s mental health to check for a psychiatric disorder.

Somatoform Disorders Treatment

  • Cognitive behavior therapy: Provides relief to the patient from the symptoms that occur as a result of the somatoform disorder. It helps to correct unrealistic beliefs and behaviors that cause anxiety and distorted thoughts that may occur in the patient’s mind without any substantial reason. It includes relaxation training, gaining control of a situation, problem-solving, visualization, breathing techniques, etc.
  • Anti-depressants: Anxiety that the individuals suffering from somatoform disorders experience may worsen the symptoms of the condition. Anti-depressants are classes of medicines that help to alleviate stress, depression, anxiety and post-traumatic stress. They may also help by influencing the nerve circuit which helps to improve fatigue, pain perception, gastrointestinal distress, etc.

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