Somatoform Disorders Confusion of Mind and Body Resemble Physical Problems but with an absence of objective clinical findings By Beth Carnes (2003)

Somatoform symptoms n Symptoms suggest physical disorder –cannot adequately be explained physiologically n Symptoms are often (but not always) described in dramatic ways n Other disorders may co-exist

Somatization Disorder (Briquet’s syndrome) n Many physical complaints n Beginning before age 30 – extend over many years n Must include –Four different pains –Two gastrointestinal symptoms –One sexual symptom –One pseudoneurological symptom n Symptoms are unfounded or exaggerated

Conversion Disorder n Physical symptoms suggesting neurological problems –Sensory impairment: Any modality –Paresthesias and paralysis n Sudden onset, sudden termination, sudden reappearance n Mostly women; men in combat n Often misdiagnosed

Pain Disorder n Main symptom is pain n May be exacerbated by psychosocial factors n May be maintained by gain

Hypochondriasis n No physical symptoms are necessary n Preoccupation with the possibility that normal sensations are symptoms of serious disease n Frequent visits to physicians n Persists despite medical reassurance n Over-report (or over emphasis) bodily sensations

Body Dysmorphic Disorder n Excessive concern with “real” or imagined defects in appearance, especially facial marks or features. n Frequent visits to plastic surgeons and estheticians n May be culturally-influenced n May be a symptom of more pervasive disorders: (i.e., Obsessive-compulsive)

Undifferentiated Somatoform D/O n c ategory for Somatoform Disorders that do not meet the criteria for a specific Somatoform D/O Must be disruptive to occupational or social achievements Because DO carries physical conditions, while obscure it first must be considered a missed physical diagnosis n Somatoform Disorder NOS –Pseudocyesis : false belief of pregnancy with abdominal enlargement and absence of menstruation without umbilical eversion present. –Hypochondriacal symptoms present for < 6 months Undifferentiated Somatoform Disorder and Somatoform Disorder NOS

How Somatoform Disorders Differ From Factitious Disorders : Somatoform Disorders present with real symptoms Lack of intentional creation of symptoms present with Factitious Disorders Somatoform Disorders are more likely to be diagnosed in a medical setting because clients are not concerned with being “found out” Not uncommon to have a mixed presentation of intentional and unintentional symptoms. In this case both Somatoform, Factitious Disorder With Predominantly Physical Signs and Symptoms or Malingering should be noted in diagnosis.