Somatic Symptom Disorders

Somatic Symptom Disorders

Somatic Symptom Disorders: broad grouping of psychological disorders that involve physical symptoms or anxiety over illness including somatic symptom disorder, illness anxiety disorder, conversion disorder (functional neurological symptom disorder), and factitious disorder

Somatic Symptom Disorder

  • Somatic Symptom Disorder (SSD): condition involving pattern of reporting distressing physical symptoms combined with extreme concern about health or fears of undiagnosed medical conditions for at least 6 months
    • Somatic symptoms: distressing physical or bodily symptoms

SSD with Predominately Somatic Complaints:

  • SSD with Predominately Somatic Complaints: a subtype of SSD involving chronic complaints of specific bodily symptoms that have no physical basis
    • 2% of women and 0.2% of men are diagnosed with this form of SSD
    • More prevalent in African Americans and those with less than a high school education or lower socioeconomic status
    • Considered a chronic condition
      • Only about half still meet criteria after one year
    • Complaints may include
      • Gastrointestinal symptoms (nausea, diarrhea, bloating)
      • Sexual symptoms (sexual indifference, irregular menses, erectile dysfunction)
      • Pseudo neurological symptoms (amnesia, breathing difficulties)

SSD with Pain Features

  • Previously known as Pain Disorder
  • Reports of severe pain that
    • (a) appears to have no physiological or neurological basis
    • (b) seems significantly greater than would be expected with an existing physical condition
    • (c ) linger long after a physical injury has healed
  • Difficult to diagnose

Illness Anxiety Disorder

  • Previously called Hypochondriasis
  • Chronic pattern (at least 6 months) of persistent health anxiety and concern that one has an undetected physical illness with no or minimal somatic symptoms
  • Participate in the following
    • Catastrophize and view ambiguous or mild somatic symptoms as indications of a severe or catastrophic illness
    • Overgeneralize by believing that serious illness and fatal conditions are prevalent
    • Display all-or-none thinking by believing they must be symptom free to be healthy
    • Show selective attention to medical information and focus primarily on threatening information

Conversion Disorder (Functional Neurological Symptom Disorder)

  • Conversion Disorder (Functional Neurological Symptom Disorder): a condition involving sensory or motor impairment suggestive of a neurological disorder but with no underlying medical cause
    • Psychogenic: originating from psychological causes
    • Symptoms:
      • Disturbances of stance and walking, sensory symptoms such as blindness, loss of voice, motor tics, dizziness, and psychogenic seizures
    • Does not incur any physical damage
    • Malingering: feigning illness for an external purpose

Factitious Disorder: a disorder in which symptoms of illness are deliberately induced, simulated, or exaggerated, with no apparent external incentive

  • Used to be called hospital addiction or professional patient syndrome
  • Signs may include:
    • Lingering unexplained illnesses with multiple surgical or complex treatments; “remarkable willingness” to undergo painful or dangerous treatments such as amputations or prophylactic double mastectomy; tendency to anger if illness is question, and involvement of multiple doctors

Factious Disorder Imposed on Another Person: a disorder in which symptoms of illness are deliberately induced, simulated, or exaggerated, with no apparent external incentive

  • Diagnosis is very difficult
  • Some believe it should be removed from DSM because it’s so hard to diagnose
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