Somatoform Disorders

Somatoform disorders are a group of conditions that include physical symptoms suggesting a medical disorder. In reality these disorders are a psychiatric condition as usually there are no medical explanations or effective medical treatments for the symptoms patients are experiencing. In many cases, medical symptoms may be a result of both a psychiatric illnesses and a medical condition.

The symptoms of somatoform disorders are serious and can affect an individual's daily life, relationships and work. Commonly they are severe enough to make a person seek medical help. Due to the complex nature of somatoform disorders, patients are often sent to mental health care professionals for further assessment, explanation and treatment. There are five typical somatoform disorders, including somatization disorder, conversion disorder, pain disorder, hypochondriasis and body dysmorphic disorder.

The symptoms of somatization disorder can include chronic headache, fatigue and other severe neurological symptoms; chronic digestive symptoms like nausea, vomiting, abdominal pain, constipation or diarrhea; or sexual symptoms such as loss of sexual desire, pain during sexual activity and highly painful menstruation periods in women. In most cases a somatization disorder can last for years. According to some studies, people who have family members suffering from this disorder are most prone to develop it themselves at some stage during their lives. In the United States, rates of somatization disorder for females are between 1 percent and 2 percent, while for males they are lower.

With conversion disorder, people develop physical symptoms that are similar to a neurological disorder. Common symptoms include paralysis of a limb, vision or hearing loss and seizures. The frequency or severity of the symptoms has been known to get worse due to factors such as stress. As a result, many medical experts believe that the symptoms have psychological origins. In general, conversion disorders develop between the ages of 10 and 35, although later development has also been reported.

A pain disorder is characterized by severe pain. Two kinds of pain disorders exist - the first starts without any known cause, while the other type of pain disorder follows a trauma. Normal pain fades away within weeks or months after an accident. In contrast the pain experienced by people with pain disorder continues for a much longer period of time. Pain that lasts more than six months is considered to be chronic pain.

Those suffering from hypochondriasis argue that any minor symptom is something far more serious. They believe a painful stomach or a slight headache is a sign of a serious illness such as stomach cancer or a brain tumor. Hypochondriasis is probably the most popular of all somatoform disorders, yet it is the least understood. The rates of the condition are between 1 percent and 5 percent of the general population. Hypochondriasis begins in the late 20s or 30s of a person's life.

With body dysmorphic disorder, an individual becomes obsessed with any physical imperfection that is actually either minor or non-existent. Common concerns for men and women who suffer from body dysmorphic disorder include hair loss, wrinkles, weight gain or loss, or the shape of the eyes or nose. People suffering from this type of somatoform disorder often think of themselves as abnormal and ugly. Medical specialists believe that body dysmorphic disorder begins during adolescence, although it may develop earlier in childhood. The rate of the disorder in the general population is estimated at around 1 percent, although sufferers rarely seek treatment.

It is important to understand that people with somatoform disorders are not pretending to be sick. The fact that there is no known reason for pain does not mean that that pain is not real. Researchers believe that there is no rule as to who might or might not suffer from any kind of somatoform disorder. A study of hospital patients has shown that 36 percent of the people meeting the criteria for somatoform disorders also suffer from depression, anxiety or some other mental health condition. In terms of treatment, cognitive behavioral therapy has been proven as an effective way to deal with somatoform disorders. Cognitive behavioral therapy examines the way thoughts and behavior can be modified in order to relieve pain. This method can be combined with conventional treatments such as medication.

Selected full-text books and articles on this topic

Mental Disorders, Medications, and Clinical Social Work
Sonia G. Austrian.
Columbia University Press, 2000 (2nd edition)
Librarian’s tip: Chap. 4 "Somatoform and Factitious Disorders"
Splintered Reflections: Images of the Body in Trauma
Jean Goodwin; Reina Attias.
Basic Books, 1999
Librarian’s tip: Chap. 3 "Assessment and Management of Somatoform Symptoms in Traumatized Patients Conceptual Overview and Pragmatic Guide" and Chap. 4 "Somatoform Dissociative Phenomena"
Handbook of Pain Syndromes: Biopsychosocial Perspectives
Andrew R. Block; Edwin F. Kremer; Ephrem Fernandez.
Lawrence Erlbaum Associates, 1999
Librarian’s tip: Chap. 28 "Somatization, Hypochondriasis, and Related Conditions"
Psychopathology: Foundations for a Contemporary Understanding
James E. Maddux; Barbara A. Winstead.
Lawrence Erlbaum Associates, 2005
Librarian’s tip: Chap. 13 "Somatoform Disorders"
Occupational Disorders: A Treatment Guide for Therapists
Martin Kantor.
Praeger, 1997
Librarian’s tip: Chap. 2 "Somatoform Occupational Disorders"
Women's Mental Health in Primary Care
Kathryn J. Zerbe.
W. B. Saunders, 1999
Librarian’s tip: Chap. 8 "Somatization"
The Neurobehavioral Treatment of Epilepsy
Yngve Løyning; David I. Mostofsky.
Lawrence Erlbaum Associates, 1993
Librarian’s tip: Discussion of somatoform disorders begins on p. 86
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