What are Somatoform Disorders
Somatoform disorders, also known as Psychosomatic disorders, refer to a psychological condition wherein a patient experiences somatic or physical symptoms for which no medical cause can be identified. Usually, when the mind is under stress, a person experiences certain bodily discomfort or symptoms such as palpitations, pain in the chest, sweating, dizziness, etc but such symptoms are short-lived. When the symptoms stay for a longer duration (more than 6 months) with no evidence of any underlying medical cause or substance abuse, the possibility of Somatoform Disorder is considered. The symptoms (most commonly pain and fatigue) for which no physical medical cause could be found, are so distressing for the patient as to affect the daily functioning of the individual.
Before diagnosing Somatoform Disorder, it is, however, important to identify and exclude factitious disorder or malingering where the patient pretends to be sick for attention or sympathy (factitious disorder) or for more physical gains such as financial compensation, avoiding a punishment (malingering). The patient with Somatic Symptom Disorder (SSD) does not fake or fabricate a story. Their suffering is real and causes extreme inconvenience to them. The criteria for diagnosing Somatic Symptom Disorders (SSD) are the presence of symptoms for 6 months or more, unexplained physical causes, and having an impact on their day-to-day activities.
Types of Somatoform Disorders:
- Somatization Disorder: Also known as Briquet’s Syndrome, it refers to a set of symptoms affecting different parts of the body simultaneously for several years without any explainable cause. Usually, starting before the age of 30, the symptoms affect mainly the gastrointestinal tract, sexual organs, and nervous system with pain in different parts of the body.
- Conversion Disorder: The physical symptoms present are of neurological nature such as difficulty in walking, paralysis, seizures, etc but no neurological cause is found. It is called conversion disorder as the psychological problem converts into a physical one. For example, loss of voice when a shy, introverted girl is asked to speak on a stage.
- Pain Disorder: As the name suggests, Pain is the main symptom of the patient. The pain could be severe, recurring, on one or multiple parts of the body with no evident cause.
- Body Dysmorphic Disorder: The patient is obsessed with the physical appearance of the body and feels the body parts are unattractive or defective. Such patients usually undergo a series of plastic surgeries as a possible treatment for the ‘defect’.
- Hypochondriasis (Illness Anxiety Disorder): It is marked by exaggerated fear of a serious, life-threatening disease. The patient is unreasonably worried about their health.
Causes of Somatoform Disorders
- Genetic or familial history of psychological illness
- Hypersensitivity to pain
- Stress and anxiety
- Inability to deal with emotional issues
Signs and Symptoms of SSD:
- Presence of physical symptoms affecting one or more parts of the body, for more than 6 months.
- Excessive worry about one’s health
- No trust in medical investigations, doctor’s advice
- Exaggerated interpretation of minor body ailments
Diagnosis of Somatoform Disorders
Since it involves physical signs and symptoms, a thorough medical examination is done to exclude any underlying condition followed by a detailed psychological assessment.
Treatment of Somatoform Disorders
Cognitive Behavioural Therapy (CBT) is the most preferred choice of treatment as it helps the patient cope with the emotional, mental, and behavioral issues associated with the disorder. As most patients are also anxious, depressed, or stressed due to their condition, antidepressants or similar medications may be prescribed to help them recover faster. Family or friends may also, be counseled to help the patient come out of the situation.