Types of Somatoform Disorders

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Types of Somatoform Disorders
2013-09-02 20:04:43
Somatoform Disorders Abnormal Psychology

Nydegger, Rudy, "Somatoform Disorders." Abnormal Psychology Through the Ages. Chp 4
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  1. Hypochondriasis
    • Intense preoccupation with the fear of contracting or suffering from a serious illness or condition.
    • Experience symptoms for at least six mths
    • Regardless of appropriate medical evaluation and ressurance, feels persistent, clincally significant distress, impairment in areas of functioning. 
    • Emerges in adolescence or young adulthood frequently. 
    • People with disorder see their problems as physical and less likely to go see mental health clinic.
    • Does tend to run in families - Comorbid anxiety, depressive disorders and other somatoform disorder as well as physical and psychological impairment. 
    • Use health services more frequently than the average person and less satisfied. 
    • Carefully monitors body, misterprets or overinterprets normal or minor sensations. 
    • Trusting that doctor is not dismissive is important
    • Educating patients about hypochondriasis and helping them control fears is key.
    • Treatments: CBT, psychodynamic therapies, family therapy, medication: antidepressants, SSRIs. 
  2. Somatization Disorder
    • Presentation of physical symptoms that had no apparent physical cause. 
    • Chronic severe disorder with many recurring physical symptoms that cannot be fully explained by a physical condition
    • Predominant symptoms begin before the age of thirty and are present for a period of years. 
    • Four different pain symptoms, two gastrointestinal symptoms, one sexual symptom, one pseudo-neurological symptom.
    • Comorbid mood/anxiety/personality disorders and are dependent on others.
    • Runs in families and more frequently in women.
    • Frustration when not cared for, dissatisfied with medical care.
    • Involves several organ systems, persists over years.
    • Treatment: Psychotropic medications, cbt/behavioral treatments. Challenge is to convince patients to stay in treatment. 
    • The disorder doesnt respond well to treatment and seem to fluctuate and persist over lifetime. -- Depression and suicidal tendency not uncommon
  3. Conversion Disorder
    • Symptoms in voluntary, motor or sensory functioning that are suggestive of, but not fully explained by, a neurological or other general medical condition or the use of substances. Cause distress, impair functioning, and individual has usually sought medical attention. Not limited to pain or sexual function. Not part of a somatization disorder, not part of another psychiatric condition. 
    • Must rule out culturally sanctioned behaviors or experiences. 
    • 5-14% of all hospital admissions
    • 5-24% of psychiatric putpatient 
    • Late childhood and early adulthood.
    • Symptoms are typically self limiting and dont lead to physical changes or disabilities, such as muscle atrophy or permanent sensory/muscular changes. Relationship difficulties are not as common as in somatization disorder.
    • Assumed that psychological conflicts are the basis of the disorder and are "converted" into physical symptoms. 
    • Psychological over-interpretation may lead cause hidden medical conditions to be overlooked. 
    • 1/3 of patients with disorder hv history of sex. abuse. 
    • Psychosocial factors are also assumed to have a role in the development of this condition.
    • Frequently found symptoms:
    • - Paralysis of the arm or leg
    • - Loss of sensation in a part of the body
    • - Seizures
    • - Loss of special sense like hearing or sight.
    • Symptoms emerge following an upsetting or traumatic social or psychological event. 
    • Conversion episodes are brief and symptoms abate within two weeks. 
    • In 20-25% patients, symptoms recur within one year. 
    • In most cases, the removal or minimization of the symptoms is the main goal. 
    • If symptoms do not respond; narcoanalysis, hypnosis, behavior therapy. 
  4. Pain Disorder
    • Suffer chronic, severe and often uncontrollable pain, involving subjective physical and psychological factors. 
    • Psychological factors have a significant role in the onset, severity, exacerbation, or maintenance of pain. 
    • Acute: Less than six months
    • Chronic: More than six months
    • Pain causes impairment in one or more of the person's basic ares of functioning - severe enough to warrant clinical intervention.

    Pain disorder is a persistent, difficult, and expensive condition, often requiring extensive diagnostic procedures and lengthy, perhaps, continuous treatment. 
  5. Body Dysmorphic Disorder
    • Severe preoccupation with an imagined defect in appearance 
    • Substantial discomfort and dysfunction in patients and is also a challenge to treat. 
    • Significant impairment in one or more of the important ares of functioning in patient's life.
    •  Cannot be explained by another psychiatric condition like OCD or anorexia nervosa.