Saint Mary’s University

Bayombong, Nueva Vizcaya

School of Health & Natural Sciences

NURSING DEPARTMENT
Course No. NCM 117 Lecture
Subject: Care of Client with Maladaptive Patterns of Behavior, Acute and Chronic
Yr. Level: BSN 3
Contact Hours/Credit Units: 4 fours/week(4units)_____________________________________

CHAPTER 15

SOMATOFORM DISORDERS

l. Introduction

A somatic symptom disorder manifests a physical symptom that suggest illness or injury but
cannot be explained by a general medical condition and are not attributed to another mental
disorder.

ll. Learning Objectives

1. Apply the moral and ethical-legal principles in dealing with the care of clients suffering somatic
symptoms.
2. Obtain a comprehensive psychiatric history and conduct a thorough assessment of mental
status of clients suffering from somatic symptoms.
3. Formulate a holistic nursing care plan for clients suffering from somatic symptoms.
4. Execute a safe, appropriate mental health activity for clients suffering from somatic symptoms.
5. Utilize effectively the therapeutic use of self in caring for clients suffering from somatic
symptoms.

lll. Core Content of the Chapter

SOMATOFORM DISORDER
- It is a form of disorder where the patient feels the presence of physical symptoms that is
with a negative organic basis. The patient feels the pain and distress which causes them to
function limitedly.
- It is also called as “doctor shoppers”
- It is a disorder that avoids responsibility and patients are manipulative.

5 TYPES of Somatoform:
1. Somatization disorder – This chronic syndrome is characterized by multiple somatic symptoms
that cannot be explained medically.
• Begins at 30 yrs. old.
• Symptoms will last within a year.
• Recurrent pain on the heart, gynecology and G.I prob.
2. Pain disorder – The pain is severe and prolonged unrelated to a medical disease.
• Pain is felt for 6 months, more exaggerated on back pain.

3. Hypochondriasis – A disorder where the person is preoccupied with bodily functions and
unrealistic beliefs of having a serious physical illness based on misinterpretation of the physical
symptoms. Person believes that they are ill.
• A small cut can lead to amputation as what the patient thinks.

4. Conversion disorder – A loss or change in bodily function. Allowing the person to resolve the
conflict through loss of a physical function. “La belle indifference”
• If the person witnessed a murder, he claimed he is blind so he was not aware of the crime.

5. Body dysmorphic – The person is preoccupied with a physical image defect in appearance
where there is no abnormality.
• If patient is with facial flows he goes to a plastic surgeon.
• A patient with normal pimple visits a dermatologist.

RISK FACTORS:
1. Gender: female 2. Age: children and adults.

NURSING DIAGNOSIS: - Impaired adjustment - Chronic pain - Sleep pattern disturbances

SIGN AND SYMPTOMS:

Pain in the absence of organic pathology.
Frequent visit to health care provider.
Preoccupied with physical symptoms, disease and physical flaws.
Symptoms of anxiety and depression.
Keeping frustration to them self.

Specific Symptoms:
Cardiovascular (fainting, hypertension, migraine, tachycardia)
Musculoskeletal (back pains, fatigue, tremors)
Respiratory (dyspnea, hyperventilation)
Gastrointestinal (abdominal cramps)
Integumentary(pruritis)
Genitourinary (difference in micturition, menstrual disturbances, sexual dysfunctions)

NURSING MANAGEMENT:
1. Offer explanation and support. (Decrease anxiety)
2. Shift focus not to the symptoms. (Convey interest to the pt. then symptoms.)
3. After complaining, check V/S
4. Encourage to assume responsibility re-physical care.
5. Stay with the patient.
6. Teach assertiveness technique. (To meet his own needs.)
7. Observe frequency and intensity. (Effective evaluation.)
8. Participate in daily activities.
9. Recognize the symptoms of the patient. Promote relief.
10. Teach stress reduction technique.
MEDICATION: Placebo Analgesic TCA (decrease somatic pain)

THERAPY: - Psychotherapy - Family Relaxation

- Behavioral therapy (they keep their frustration to themselves) internalization

NOTE:
Persistent “somatizers” are dependent, emotional, needy, frustrated, chronically resentful person,
seeking attention. They want to punish relatives and doctors for not meeting their needs

V. Activity:
Long Quiz
Short Quiz

V. Bibliography:
Videbeck, S. (2020). Psychiatric-Mental Health Nursing. Wolters
Keltner, N., Bostrom C., & McGuiness T. (2012). Psychiatric Nursing. Elsevier Inc.

Prepared by:

Mrs. Rosalie C. Carreon, RN, MSN

Nursing Department