1. Mental Health Nursing-NUR 413 Lecture 7
Somatoform Disorders
Mental Health Nursing-NUR 413
Lecture 7

2. Introduction Disorders characterized by:
Physical symptoms/physical disability
The person’s psychological problems are manifesting as physical/medical complaints
Symptoms NOT secondary to known medical condition or substance abuse

3. Introduction Three central features of Somatoform Disorders:
Physical complaints without organic basis
Psychological factors and conflicts seem important in initiating, exacerbating, and maintaining the symptoms
Symptoms or magnified health concerns are not under conscious control

4. Somatoform Disorders Types of Somatoform Disorders
Somatization Disorder
Pain Disorder
Hypochondriasis
Body Dysmorphic Disorder
Dissociative Disorders
Dissociative Fugue
Dissociative Identity Disorder

5. Somatization Disorder
Multiple recurrent physical complaints over many years
No organic etiology for these complaints
Pain, GI, sexual, pseudoneurologic symptoms: impaired coordination or balance, paralysis or localized weakness, difficulty swallowing, urinary retention, hallucinations, loss of touch or pain sensation, double vision, amnesia, sensory losses, loss of consciousness
female: male 10:1

6. Pain Disorder Often a history of real injury or illness
Physical symptom of pain-one or more anatomic sites
May occur with a General medical condition
Pain –not relieved by analgesics
Onset, severity, exacerbation and maintenance affected by psychological stressors

7. Hypochondriasis
Client is preoccupied with fear that he/she has or will get a serious disease
They may believe that minor complaints are signs of very serious medical problems.
History of seeing many doctors
Significant distress/impairment in function
Normal bodily functions/real symptoms are misinterpreted
Tests with normal results gives no lasting satisfaction for the patient
> 6 months duration minimum
Male = Female

8. Body Dysmorphic Disorder
Preoccupation with imagined or exaggerated defects in physical appearance
Causes clinically significant stressor impairment in social or occupational function… person may undergo repeated plastic surgeries for nose repair or to change face etc.

9. Dissociative Disorders
DISSOCIATIVE AMNESIA:
One or more episodes of inability to recall personal information
Information is usually of a traumatic or stressful nature
Not due to effects of substance abuse

10. Dissociative Fugue Sudden unexpected travel away from home or work
Unable to recall past (or where on has been)
Confused about personal identity/ or assumes new identity

11. Dissociative Identity Disorder
Individual demonstrates two or more distinct identities or personality states
Each personality is distinct
At least two of these personality states take control of the individuals behavior.
Unable to recall extensive personal information

12. Treatment for Somatoform Disorders
As a general rule, therapy is the most effective treatment for somatoform disorders. Since these disorders usually involve underlying irrational thoughts and beliefs, Cognitive Behavioral Therapy – which focuses on helping people identify and change errors in their thinking - is believed to be one of the most effective types of therapy for these disorders. Medication may be used to alleviate concurrent symptoms of anxiety or depression, but is usually not an effective form of treatment for somatoform disorders.