iPsychology

Index

Somatoform Disorders Types

Alternative Medicine
Causes and symptoms
Definition
Prevention
Prognosis
Treatment ( Psychotherapy )
Treatment ( Pharmacotherapy )

Somatoform Diagnosis Flow Chart
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Definition

Physical symptoms that seem as if they are part of a general medical condition, however no general medical condition, other mental disorder, or substance is present. In this case psychological conflicts may becoming translated into physical problems or complaints. With the number one complaint being of some type of physical symptom,  it is no wonder this disorder is often discovered in a general medical setting.

This disorder encompasses several health disorders. The disease affects the daily activities of the patient. The patients do have a strong believe that they are sick and in turn might not be faking the illness. The disease is hard to be tested from many tests and it makes the patient more worried. Their treatment requires a lot of attention and the best treatment would be the family relationship. Nevertheless, many forms of treatment have worked on the disorder, which need a lot of care on the patient.

There is no physical identifiable cause of the disease though there may be physical symptoms such as nauseas, depression, pain, and dizziness. Somatoform disorder is also known as briquet’s syndrome, Pain disorder, or Body dysmorphic disorder. This disorder has a variety of mental health disorders in which the main cause is not a specific physical symptom but it manifests itself as a physical disorder. The symptoms that the patients do have are many and they last for a long time preferably years due to them not being able to be narrowed to a specific physical cause.

However, these disorders do have their age group, many of the young and adolescents are affected by conversion disorders although there might be cases that involve dysmorphic disorders too.

Parents are being accused on the conversion disorder, as they are more attentive on the child’s symptoms.

Causes and symptoms

The disorder is mainly due to the family stresses, parental modeling, cultural influences, and biological factors. These causes bring about the state where many of the patients do have chronic headaches, pain in the back, nausea, muscle cramps, and arthritis.

• Somatization Disorder
• Undifferentiated Somatoform Disorder
• Pain disorder – appears largely to come from the patients psychological factors, it is more commonly in the older age and the ration is nearly equal 2:1,
• Conversion disorder – is where the patient’s senses of mobility are impaired with no cause only stress being the main factor.
• Hypochondriasis – is mostly related to the stresses that one faces in life, it is marked by fear and lack of assurance. It is now in all age groups it is no long a disorder for the grown adults nut also the adolescents and children,
• Body dysmorphic disorder – is a disorder that affects the features on the face or head that are exaggerated.
• Somatoform Disorder not Otherwise Specified ( NOS )

The patient needs the greatest care in the administration of the treatment and it should be monitored at all times. The treatment has to be either medications, a firm relationship with a single practitioner, psychotherapy, and alternative medicine.

Psychotherapy

• Adlerian Therapy
• Behavior Therapy
• Existential Therapy
• Gestalt Therapy
• Person-centered Therapy
• Psychoanalytic
• Rational-emotive Therapy
• Reality Therapy
• Transactional Analysis

Pharmacotherapy

Alternative Medicine

Basically, our mentality or intellectual mind can be a source of our body to generate bodily symptoms or it worsens our physical illness.  This physical symptoms may continue and eventually be worsened due to emotional factor that a person my felt.  When this person encountering a lot of stresses or the person cannot cope to the stress, its physical symptoms worsen.  On the works of Sigmund Freud, he observed that people with hysteria can improve their condition (relieving their physical symptoms) through hypnosis and recalling their memories and expressing their emotions and this process is what we called as Somatization (Hollifield, 2005).

Somatoform Disorder is a group of problems or disorders, which is characterized by persistent physical signs, which can be an indicative of a medical disorder or problem without demonstrable basis.  Nevertheless, this disorder suggests a psychiatric condition.  The origin of this disorder to human body is still unknown.  But, some studies showed that primary somatoform disorders is somewhat relates the occurrence of heightened awareness (severe emotional distress and stress) of the normal bodily sensations of a person.  Such this occurrence in the body, our body converts this as physical symptoms without medical basis.  The incidence of this disorder to human lives is occurs predominantly to women than in men with the ratio of 10:1 (Yates, 2008).  According to the Diagnostic and Statistical Manual for Mental Disorder, 4th edition (DSM-IV-TR), they set up categories for somatic symptoms and it can be called as the somatoform disorder: (1) Somatization Disorder, (2) Conversion Disorder, (3) Pain Disorder, (4) Hypochondriasis and lastly 5 Body Dysmorphic Disorder (BDD). And this is further discussed below (American Psychiatric Association, 2000).

First on the list among somatoform disorder is: Somatization disorder,  a kind of disorder in which a person experiences various physical symptoms with no known medical origin.  Basically, the person who have this kind of disorder (begins by 30 years of age), normally complains multiple and chronic unexplained physical symptoms that may occur in different sites simultaneously, and he may also complains gastrointestinal, sexual or pseudoneurological symptoms.  Next in the list of disorder is Hypochoriasis is characterized by unexplained physical symptoms that can be directly related to fear that other person has contracting disease (disease conviction) or fear that he may acquire those identified disease (disease phobia).  They are also still worried about their body despite a medical evaluation results ha been presented to him. And this fear may last at least 6 months.  Another disorder that is covered, Conversion disorder, a person who have this kind of disorder experiences  sudden loss of neurological functions, usually this is the result of having severe stress felt by the body of the client.  It can be one or multiple loss of voluntary motor or sensory function.  It is said there were no evidence that showed that the occurrence of this symptoms is intentionally used by patient.  Furthermore, it’s lost of function is not also associated to medical illness or patient response to cultural behavior but it may suggest that it can be associated with psychological factors.  Following is, Pain disorder, it is termed when a patient complains severe focused pain that cannot be attributed or relate the pain to specific medical disorder and cannot be relieved by analgesic.  This pain can arise in one or more anatomical site and it is not intentionally done by the people who have it.  Body Dysmorphic Disorder is another form of somatoform disorder in which a patient think that he or she has a defect in his or her body well in fact there is none; this can further be associated to unsuccessful attempts to correct the patient’s image, through undergoing series of cosmetic surgery.  Aside from these identified disorder, somatoform disorder need to classify from other bodily-related mental disorder such as malingering and factitious disorder.  This disorder is intentionally produced by the person for some purpose or something to get.  A person who malingers is intentionally using a false or grossly exaggerated physical or psychological symptoms motivated by external reason such as avoiding to work, go to his appointment, ect.  As soon as the person malingers gained what they want, their physical symptoms will stop.  While, Factitious disorder, a person is intentionally produces physical or psychological symptoms (may injure them selves) because they want to gain attention.

Many alternative ways that can be used to treat somatoform disorder.  Psychosocial interventions can incorporate to this somatoform disorder.  A nurse or any medical staff may incorporate or give the patient a Cognitive Behavioral Psychotherapy which in turn very useful in reducing the distress felt by the patient as well as it reduces the patient from taking or undergoing medical evaluation.  Psychoeducation can also be useful tool to that explains a stress or any emotional distress can be factors for having physical symptoms.  Specific intervention for specific somatoform disorders is now presented.  Medical treatment focused on the management of the symptom like decreasing the bodily disturbances where in the psychopharmacological treatments addresses the emotional disturbances and comorbid psychiatric symptoms.   Relaxation, biofeedback and stress management is a great help in decreasing the emotional and bodily arousal.  Psychological interventions are also useful like the attention training, using distraction tools, hypnosis or environmental manipulation that reduces in attention to the body and its awareness of physiological disturbances (Looper, 2002).  Patients with Somatization disorder usually refuses to undergo psychotherapy because they already set in mind that the physical symptoms that they have is in fact an illness.  In Conversion disorder, Behavior therapy or hypnosis is very useful to this disorder.  Stress management counseling is used prevent the recurrence of the abnormal gait, which was understood as a maladaptive response to stress.  Hypnosis can also be used in this disorder.  Other treatment is useful like the use of electromyography biofeedback, behavioral reinforcement combined with strategic “double bind” therapy, hypnosis combined with lorazepam and amobarbital interviewing.  In Hypochondriasis disorder, the physician should answer all the questions given by the patient, in this way the patient might reduce his anxiety through the physician’s explanations (or explanatory therapy).

People who have this disorder may other think that they are doing it exaggeratedly but as part of the medical team we should let this people understand their condition well in fact they do not intentionally produced it.  One way to help this people is by encouraging letting their feelings be expressed.  Psychosocial theorist believed that they keep stress, anxiety or frustrations inside them rather than expressing them outwardly (internalization).  By encouraging them to articulate their emotions and using the alternative medicine presented above, it is possible for this person to relieve the disorder.