SOMATOFORM DISORDER By Dr. Hena Jawaid

Somatoform disorders Disorders in this category include those where the symptoms suggest a medical condition but where no medical condition can be found by a physician. In other words, a person with a somatoform disorder might experience significant pain without a medical or biological cause, or they may constantly experience minor aches and pains without any reason for these pains to exist.

Somatoform disorders 1.Somatization disorder 2.Conversion disorder 3.Hypochondriasis 4.Body dysmorphic disorder 5.Pain disorder

Somatization disorder- DSM IV TR Many physical complaints beginning before age 30 years result in treatment being sought or significant impairment of functioning 4 pain symptoms 2 gastrointestinal symptom 1 Sexual symptom 1 pseudo-neurological symptom

Somatization disorder- DSM IV TR Cannot be fully explained by a known general medical condition Physical complaints or resulting social or occupational impairment are in excess of what would be expected The symptoms are not intentionally produced or feigned

Somatization disorder- DSM IV TR Treatment long term therapy. The involvement of a single physician is important as a history of seeking medical attention and ‘doctor shopping’ is common. Prognosis Is typically a chronic condition with a variable course. do not experience any significant difference in mortality rate or significant illness.

Hypochondriasis Preoccupation with fears of having a serious disease based on misinterpretatio n of bodily symptoms

Hypochondriasis Preoccupation persists despite appropriate medical evaluation and reassurance. Preoccupation is not of delusional intensity Clinically significant distress or impairment in functioning. At least 6 months

Hypochondriasis Treatment Therapy is difficult with individuals with this disorder due to their strong belief that the symptoms are not psychological. Sometimes reframing therapy as ‘stress-reduction training’ can assist in the acceptance of help. Prognosis Poor. The course of hypochondriasis is typically chronic, with periods of higher functioning

Body dysmorphic disorder Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person’s concern is markedly excessive. Preoccupation causes clinically significant distress or impairment in functioning.

Body dysmorphic disorder Treatment Disorder is most often gradual, taking several months or years to develop, intervention is difficult. Therapy is typically refused by individuals Prognosis Mixed. Some recent studies suggest good results with medications such as antidepressants.

Pain Disorder Psychological factors have a role in onset, severity, exacerbation or maintenance of pain Common Medical: Musculoskeletal (disc herniation, arthritis), Neuropathies (diabetic, post- herpetic), Malignancies Intensity incompatible with known physiological mechanism or anatomy

Pain Disorder Treatment Pain symptoms may decrease with therapy and improvements in social and interpersonal functioning Prognosis Poor. The course is typically chronic and persists for years, and often involves other symptoms such as depression, anxiety, and drug abuse.

“In safety, do not forget danger; in peace, do not forget disorder” - Unknown author