Somatization, Hypochondriasis, and Related Conditions
Stefan Lautenbacher University of Marburg, Germany
Gary B. Rollman University of Western Ontario, Canada
Medical patients often present with physical symptoms, including pain, that have no apparent somatic cause. The complaints are frequently accompanied by anxiety, depression, and denial of psychological problems ( Dworkin, 1994; Dworkin, Wilson, & Massoth, 1994). In such cases, subclinical or clinical forms of somatoform disorders should be considered. These are conditions in which psychological conflicts and problems have taken the form of a somatic illness ( Ford, 1995).
According to the Diagnostic and Statistical Manual of Mental Disorders ( 4th ed., DSM-IV) ( American Psychiatric Association [APA], 1994), somatoform disorders are subdivided into five specific conditions: body dysmorphic phobia, hypochondriasis, somatization disorder, conversion disorder, and pain disorder. As well, there are two residual diagnostic categories: undifferentiated somatoform disorder and somatoform disorder not otherwise specified. Many other labels, such as hysteria, functional complaints, vegetative dystonia, and Briquet's syndrome, have previously been used to describe similar conditions. Not infrequently, disorders such as asthma, peptic ulcer, esophageal motility disorder, or nonulcer dyspepsia have been erroneously mixed with somatoform disorders; the former have a clearly more distinct psychophysiological basis ( Kellner, 1994; Salkovskis, 1996).