Somatoform Disorder

Somatoform disorder describes a group of conditions where one’s physical symptoms are closely related to some psychological factors. The symptoms cannot be explained by specific physical causes, and medical tests reveal normal results or are not able to explain one’s symptoms. People who have somatoform disorder usually undergo repeated medical evaluations to make sure they do not have any illness. They are often worried about their health since they do not know what is causing their physical problems. Symptoms are often long-lasting and are similar to those of other disorders or diseases. However, they are not faking their symptoms, as others might think.

Symptoms of Somatoform Disorder

1. General Symptoms

People with somatoform disorder experience various physical symptoms involving different parts of the body such as:

  • Ÿ   Headaches
  • Ÿ   Nausea
  • Ÿ   Abdominal pain
  • Ÿ   Tiredness
  • Ÿ   Bowel problems
  • Ÿ   Menstrual problems
  • Ÿ   Sexual problems

Symptoms vary at different times and may significantly affect their daily life. Affected individuals tend to be emotional and may describe their symptoms as "unbearable" or "terrible". Symptoms vary in severity but they generally persist for long periods.

2. Symptoms of Different Types of Somatoform Disorder

There are different types of somatoform disorder and their symptoms are different.

  • ŸSomatization disorder. This type usually involves pain and severe digestive symptoms (nausea, vomiting, constipation, diarrhea and abdominal pain), neurological symptoms (headache, fatigue), and sexual symptoms (loss of desire for sex, pain during sex, extremely painful periods).
  • ŸHypochondriasis. This occurs when one believes that normal body function (like stomach grumbling) or some minor symptoms (like headache) are linked to a serious disorder such as cancer.
  • ŸBody dysmorphic disorder. This occurs when one becomes obsessed with a flaw in their physical appearance that is just a minor flaw or does not even exist. The individual may constantly worry about wrinkles, weight gain, hair loss, or the size and shape of their eyes, nose or breasts, even if there is nothing seriously wrong with them.
  • ŸConversion disorder. This occurs when physical symptoms are similar to those of a neurological disorder, even when there is no neurological disorder present. This may manifest as paralysis of a leg, loss of vision, hearing loss or seizures, which are the most common symptoms of neurological disorders. Symptoms may worsen with stress.
  • ŸPain disorder. This disorder is quite common. Pain may be related with psychological factors at the onset, but it may later be associated with some medical problem. Pain perception may lead to social inactivity and isolation, which may cause anxiety, depression and substance abuse.
  • ŸUndifferentiated somatoform disorder. Similar to somatization disorder, but less specific, it happens to people who have one or more unexplained symptoms for at least 6 months.

Causes of Somatoform Disorder

People can have a somatoform disorder at any age. It is difficult to determine how many people are affected by the condition since many probably remain undiagnosed. Somatization disorder is not very common (1 in 1,000 people) and body dysmorphic disorder and hypochondriasis are more common.

The cause of somatoform disorders is not clear, but genetic and environmental factors probably play a role. Genetic factors inherited from parents control various aspects of health, and when combined with other factors such as child-rearing, peer influences and other environmental stimuli, these may contribute to the development of the disorder.

Alcohol and drug abuse are also known to play a significant role in causing somatoform disorders. However, it is also possible that some people may use alcohol or drugs to ease their symptoms. To others, excess alcohol intake or drug abuse may make their symptoms worse.

Treatments for Somatoform Disorder

It is hard to treat patients of somatoform disorders because affected individuals usually do not accept that their symptoms are related to psychological factors. They may react with anger when their doctors cannot find a physical cause for their symptoms. Furthermore, people with somatization disorder may later develop physical disorders with new symptoms, which can present another challenge for their doctor to investigate.

Many people who have a somatoform disorder may also have mental health issues such as substance abuse, anxiety or depression. Treatment of these problems may improve their symptoms.

Patients who accept that their physical symptoms may be linked to mental factors are more likely to receive talking treatments such as cognitive behavioral therapy. This may help them understand what causes the problem. This type of treatment aims to change false beliefs and help them deal with emotional problems.

Medications do not help much except if the somatoform disorder is accompanied by anxiety or depression. Selective serotonin reuptake inhibitors (SSRIs) are drugs that have been used for people with pain disorder and body dysmorphic syndrome.

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