Somatoform disorders

Somatoform disorders

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Somatic Somatoform Disorders involves a person having a significant focus on physical symptoms, such as pain, weakness or shortness of breath, that results in major distress.

A person is not diagnosed with somatic symptom disorder solely because a medical cause can’t be identified for a physical symptom. The emphasis is on the extent to which the thoughts, feelings and behaviours related to the illness are excessive or out of proportion.

When physical symptoms are caused by psychologicalor emotional factors it is called somatisation.

Somatoform Disorders Symptoms:

  • Specific sensations, such as pain or shortness of breath, or more general symptoms, such as fatigue or weakness
  • Unrelated to any medical cause that can be identified, or related to a medical condition such as cancer or heart disease, but more significant than what’s usually expected
  • A single symptom, multiple symptoms or varying symptoms
  • Mild, moderate or severe

These thoughts, feelings and behaviours can include:

  • Constant worry about potential illness
  • Viewing normal physical sensations as a sign of severe physical illness
  • Fearing that symptoms are serious, even when there is no evidence
  • Thinking that physical sensations are threatening or harmful
  • Feeling that medical evaluation and treatment have not been adequate
  • Fearing that physical activity may cause damage to your body
  • Repeatedly checking your body for abnormalities
  • Frequent health care visits that don’t relieve your concerns or that make them worse
  • Being unresponsive to medical treatment or unusually sensitive to medication side effects
  • Having a more severe impairment than is usually expected from a medical condition

For somatic symptom disorder, more important than the specific physical symptoms you experience is the way you interpret and react to the symptoms and how they impact your daily life.

Somatoform Disorders Cause:

  • Genetic and biological factors, such as an increased sensitivity to pain
  • Family influence, which may be genetic or environmental, or both
  • Personality trait of negativity, which can impact how you identify and perceive illness and bodily symptoms
  • Decreased awareness of or problems processing emotions, causing physical symptoms to become the focus rather than the emotional issues
  • Learned behaviour, the attention or other benefits gained from having an illnessor pain behaviours in response to symptoms, such as excessive avoidance of activity, which can increase your level of disability

Somatoform Disorders Types:

Hypochondriasis

Patients with hypochondriasis misinterpret physical symptoms and fixate on the fear of having a life-threatening medical condition.

This is a disorder where people fear that minor symptoms may be due to a serious disease. 

Conversion disorder

Conversion disorder involves a single symptom related to voluntary motor or sensory functioning. 

  • Total loss of vision
  • Deafness.
  • Weakness, paralysis or numbness of the arms or legs.

Body dysmorphic disorder

Body dysmorphic disorder is a condition where a person spends a lot of time worried and concerned about their appearance. Body dysmorphic disorder involves a debilitating preoccupation with a physical defect, real or imagined.

In the case of a real physical imperfection, the defect is usually slight but the patient’s concern is excessive. 

Pain disorder

Pain disorder is a condition where a person has a persistent pain that cannot be attributed to a physical disorder.

Although the pain is associated with psychological factors at its onset (e.g., unexplained chronic headache that began after a significant stressful life event), its onset, severity, exacerbation, or maintenance may also be associated with a general medical condition. 

Risk factors:

  • Having anxiety or depression
  • Having a medical condition or recovering from one
  • Being at risk of developing a medical condition, such as having a strong family history of a disease
  • Experiencing stressful life events, trauma or violence
  • Having experienced past trauma, such as childhood sexual abuse
  • Having a lower level of education and socio-economic status

Somatoform Disorders Treatment:

The goal of treatment is to improve your symptoms and your ability to function in daily life. Psychotherapy, also called talk therapy, can be helpful for somatic symptom disorder.

Sometimes medications may be added, especially if you’re struggling with feeling depressed.

Psychotherapy

Because physical symptoms can be related to psychological distress and a high level of health anxiety, psychotherapy, specifically, cognitive behavioural therapy (CBT) — can help improve physical symptoms.

CBT can help you:

  • Examine and adapt your beliefs and expectations about health and physical symptoms
  • Learn how to reduce stress
  • Learn how to cope with physical symptoms
  • Reduce preoccupation with symptoms
  • Reduce avoidance of situations and activities due to uncomfortable physical sensations
  • Improve daily functioning at home, at work, in relationships and in social situations
  • Address depression and other mental health disorders

Family therapy

Family therapy may be helpful by examining family relationships and improving family support and functioning.

Medications

Antidepressant medication can help reduce symptoms associated with depression and pain that often occur with somatic symptom disorder.

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