SOMATIC SYMPTOM DISORDER
- Group of conditions
- ' Soma' means Body
- Involves patterns in which individuals complain of bodily symptoms.
Four disorder in the Somatic symptom and Related Disorder category:
1. Somatic Symptom Disorder
- Includes several disorder that were previously considered to be separate diagnose in DSM-IV (1) Hypochondriasis (2) Somatization Disorder (3) Pain Disorder
*Individuals must be experiencing chronic somatic symptom that are distressing to them. They must also experience:
- Dysfunctional thoughts, feelings and/or behavior
- Disproportionate and persistent thoughts about the seriousness of one's symptoms.
- Persistent high level of anxiety about health or symptom and/or;
- Excessive time and energy devoted to these symptoms or health concerns
These symptoms have to persist for at least 6 months for the diagnosis.
1.1 Hypochondriasis
- Person is preoccupied with a concern that they have a serious disease. They believe that a minor complaints are signs of a very serious medical problems (e.g. headache is a sign of brain tumor).
- Occurs about equally often to men and women.
- Early adulthood is the most common age of onset.
Treatment
- Cognitive-Behavioral Treatment
1.2 Somatization Disorder
- Characterized by many different physical complaints.
- Had to begin before the age of 30 and lasts for several years.
- Usually begins in adolescence
- Three to ten times more common among women.
- Occurs more among less educated individual and in lower socioeconomic status classes.
*Somatization Disorder runs in families and there is a familial linkage between Antisocial Personality Disorder in men and Somatization Disorder in women.
Treatment
- Moderately effective treatment involves one physician who will integrate the patient's care by seeing the patient in regular visits and providing physical exams focused on new complaints and can be even more effective with Cognitive-Behavioral Therapy.
1.3 Pain Disorder
- Persistent and sever pain in one or more areas of the body.
- May be acute (less than 6 months) or chronic (more than 6 months)
- Pain that is experienced is very real and can hurt as much as pain that comes from other sources.
- Diagnosed more frequently in women.
- People with these disorder are often unable to work or perform some other usual daily activities.
Treatment
- Cognitive-Behavioral Techniques
- Treatment programs like:
● Relaxation Program
● Support and validation that the pain is real
● Cognitive restructuring
● Reinforcement of 'no-pain' behaviors
● Anti-depressant medications and some SSRIs to reduce pain intensity.
2. Illness Anxiety Disorder
- High anxiety about having or developing a serious illness. This anxiety is distressing and/or disruptive but have a few or mild somatic symptom.
3. Conversion Disorder (Functional Neurological Symptom Disorder)
- Condition where people have neurological symptoms that can't be traced back to a medical cause.
- The term conversion disorder is relatively recent. Historically, it was one of the several disorders grouped together under Hysteria.
- Occur two to three times more often in women and occur between early adolescence and early adulthood.
Range of symptoms (Four categories)
1. Sensory
2. Motor
3. Seizure
4. Mixed presentation of the three.
Examples are:
- Weakness or Paralysis
- Abnormal movements
- Hearing loss
- Blindness
- Loss of sensation or numbness
Treatment
- Behavioral Approach
● specific exercises are prescribed to increase movement or walking.
- Cognitive-Behavioral Therapy
- Hypnosis
● Hypnosis or adding hypnosis to other therapeutic techniques can be useful.
4. Factitious Disorder
- Intentionally produces psychological or physical symptoms.
- Patients secretly do something to change their own physiology (e.g. by taking drugs) in order to simulate various real disease.
4.1 Malingering
- Person is intentionally producing or grossly exaggerating physical symptoms.
References:
- DSM-V
- https://www.webmd.com/mental-health/somatoform-disorders-symptoms-types-treatment
