Meaning and Definition —

Psycho-physiological disorder is also known as psychosomatic disorder. Psycho-

physiological disorder is mainly caused by psychological and emotional rather than by
physical and organic. In other words, psychological problems are expressed through
some physiological pathology. According to Alexander (1950) – each type of
psychosomatic disorder may be connected with specific type of stress. It was found that
peptic ulcer associated with the frustration of love need and the need for protection.
Frustration of these need cause anger and anxiety which stimulates secretion of acid in
stomach. This leads to peptic ulcer.

DSM II defines the psycho-physiologic disorder as – "characterized by physical

symptoms that are caused by emotional factors and involve a single organ system
usually under autonomic nervous system." (American Psychiatric Association 1968).

Psycho-physiologic disorder include a wide range of dysfunction in which strain and

stress of life plays a crucial role.

Classification of Psycho-physiologic Disorders :

1. Psycho-physiologic cardiovascular disorders: hypertension, coronary,

disease, migraine etc.

2. Psycho-physiologic gastrointestinal disorders: it includes- peptic ulcer,

colitis, gastritis etc.

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3. Psycho-physiologic respiratory disorders : it includes-
bronchial asthma, tuberculosis, common cold etc.

4. Psycho-physiologic skin disorders : includes neurodermatosis,

eczema, itching etc.

5. Psycho-physiologic genitourinary disorders : disturbances in

menstruation and urination.

6. Psycho-physiologic endocrine disorders : hyperthyroidism,

obesity, endocrine disorder.

7. Psycho-physiologic musculoskeletal disorders : headache, case of

arthritis, muscle cramps etc.

8. Psycho-physiologic disorders of organs of special sense:

chronic conjunctivitis.

9. Psycho-physiologic hemic and lymphatic disorders :

disturbances in the blood and lymphatic system.

10. Psycho-physiologic disorders of other types : disturbances in the nervous

system in which emotional factors play a crucial role- multiple sclerosis.

Psycho-physiologic Cardiovascular Disorders

Coronary Heart Disease : This disorder is the outcome of emotional stress. Coronary
heart disease and hypertension or high blood pressure are the two most important type
of frequently occurred heart disease. It is observed that worry, anxiety, irritation and
excitement increase heart palpitation. It resisted the flow of blood and also increase
clotting of blood which causes obstruction to arteries.

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Psycho-physiologic Gastrointestinal Disorders

Peptic Ulcer : The gastro intestinal system is a common path through which human
being express their emotion. People experience pain in upper abdomen along with the
symptoms of nausea and vomiting chronic repressed hostility, worry, anxiety, constant
resentment and anguish and other stressful state stimulate the flow of stomachs acid
and juices. This gastric secretions destroys the lining of the stomach is called
duodenium and leaves a crater like wound called ulcer.

Psycho-physiologic Respiratory Disorders

Asthma : It is a quite common respiratory disorder. Asthma is found to be elevated by

emotional stimuli. It was observed that most of the times asthmatic attack not due to
particular allergens rather it seemed to be directly related to difficulty in handling
aggression and hostility aroused out of interpersonal relationship.

Psycho-physiologic Skin Disorders

Eczema : It is a superficial inflammation of the skin characterized by redness, itching

and formation of crusts. As the skin is highly sensitive indication of emotional stress.
Severe stress and emotional distress also may develop psychosomatic skin reactions
such as rashes, eczema. Brown (1972) stated a positive relationship between eczema and
emotional stress. It was also proved that eczema reactions related with emotional stress
clear up when the stress situation alleviated.

Psycho-physiologic Genital Disorders

Urinary Problem : Disorders in the urinary functions due to emotional conflicts

come under this category. Many people complaint of frequent urination or other urinary
troubles though there is no real organic pathology.

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It is also caused due to worries, anxiety and emotional stresses. Bed wetting is a
common behaviour disorders during childhood is caused by this disorder.

Etiology of Psycho-physiological Disorders :

A. Biological Factors

1. Genetic Factors : It was observed that to some extent specific genetic factors
are responsible for this disorder- Asthma, ulcers, migraine and hypertension in
greater frequencies have been reported in close relatives of the patients.

2. Differences in autonomic reactivity : This disorder is the outcome of

individuals primary reaction tendencies to stress- different children reacts
differently to some stress by developing specific types of physiological disorder
like fever, indigestion, sleep disturbances etc.

3. Somatic Weakness : Some studies stated that psychosomatic disorders occur

specially in the weak of interior organ of the body which is produced usually
due to heredity, illness and trauma.

B. Psychosocial Factors

i. Personality Factors : Individuals attitude towards stressful situation and the

coping pattern which he adopts are the reason in the development of psycho-
physiological disorders. Though personality factors are not solely accountable
for the total cause of psycho-physiological disorders.

ii. Interpersonal relationship : Some studies indicate the relationship

between pathogenic family pattern to psychophysical illness. Marital
unhappiness, separation, divorce, death of near

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 one's, and other stressful interpersonal relationship may influence
psychophysical logical disorders.

C. Socio-cultural Factors

Psycho-physiologic disorders may vary in incidence from culture to culture and

society to society. It was observed that psychosomatic disorders are rarely found
in primitive people but with the time of modernization it is frequently occurred in
developed societies. Some have the idea that Socio-Economic Statues (SES) may
be a reason behind this disorder.

Treatment :

i. Use of tranquilizers for reducing emotional tension.

ii. Behavioral therapy

iii. Family Therapy

The various treatment methods should be applied as and when necessary,

keeping in view the nature of the disease and condition of patient.

Somatic Disorder
Somatic symptom disorder (SSD formerly known as "somatization disorder" or "somatoform
disorder") is a form of mental illness that causes one or more bodily symptoms, including
pain. The symptoms may or may not be traceable to a physical cause including general
medical conditions, other mental illnesses, or substance abuse. But regardless, they cause
excessive and disproportionate levels of distress. The symptoms can involve one or more
different organs and body systems, such as:

 Pain
 Neurologic problems
 Gastrointestinal complaints
 Sexual symptoms

Many people who have SSD will also have an anxiety disorder.
People with SSD are not faking their symptoms. The distress they experience from pain and
other problems they experience are real, regardless of whether or not a physical explanation
can be found. And the distress from symptoms significantly affects daily functioning.
Doctors need to perform many tests to rule out other possible causes before diagnosing SSD.
The diagnosis of SSD can create a lot of stress and frustration for patients. They may feel
unsatisfied if there's no better physical explanation for their symptoms or if they are told their
level of distress about a physical illness is excessive. Stress often leads patients to become
more worried about their health, and this creates a vicious cycle that can persist for years.

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 Disorders Related to Somatic Symptom Disorder
Several conditions related to SSD are now described in psychiatry. These include:

 Illness Anxiety Disorder (formerly called Hypochondriasis). People with

this type are preoccupied with a concern they have a serious disease. They may believe
that minor complaints are signs of very serious medical problems. For example, they
may believe that a common headache is a sign of a brain tumor.
 Conversion disorder (also called Functional Neurological Symptom
Disorder). This condition is diagnosed when people have neurological symptoms
that can't be traced back to a medical cause. For example, patients may have symptoms
such as:
o Weakness or paralysis
o Abnormal movements (such as tremor, unsteady gait, or seizures)
o Blindness
o Hearing loss
o Loss of sensation or numbness
o Seizures (called nonepileptic seizures and pseudoseizures) 

Stress usually makes symptoms of conversion disorder worse.

 Other Specific Somatic Symptom and Related Disorders. This category

describes situations in which somatic symptoms occur for less than six months or may
involve a specific condition called pseudocyesis, which is a false belief women have that
they are pregnant along with other outward signs of pregnancy, including an
expanding abdomen; feeling labor pains, nausea, fetal movement; breast changes; and
cessation of the menstrual period.

Treatment of Somatic Symptom Disorders

Patients who experience SSD may cling to the belief that their symptoms have an underlying
physical cause despite a lack of evidence for a physical explanation. Or if there is a medical
condition causing their symptoms, they may not recognize that the amount of distress they
are experiencing or displaying is excessive. Patients may also dismiss any suggestion that
psychiatric factors are playing a role in their symptoms.
A strong doctor-patient relationship is key to getting help with SSD. Seeing a single health
care provider with experience managing SSD can help cut down on unnecessary tests and
treatments.
The focus of treatment is on improving daily functioning, not on managing symptoms. Stress
reduction is often an important part of getting better. Counseling for family and friends may
also be useful.
Cognitive behavioral therapy may help relieve symptoms associated with SSD. The therapy
focuses on correcting:

 Distorted thoughts
 Unrealistic beliefs
 Behaviors that feed the anxiety

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 Somatic Symptom Disorder
Some people have excessive and unrealistic worries about their health. They are very worried
about getting a disease or are certain they have a disease, even after medical tests show they
do not. And these people often misinterpret minor health problems or normal body functions
as symptoms of a serious disease. An example is a person who is sure that their headaches are
caused by a brain tumor. This condition used to be called hypochondria. Now it is called
somatic symptom disorder. The symptoms associated with somatic symptom disorder are not
under the person's voluntary control, and they can cause great distress and can interfere with
a person's life.
Somatic symptom disorder can happen at any time of life, but most often begins in early
adulthood. It affects men and women equally.
 

What Are the Features of Somatic Symptom Disorder?

People with somatic symptom disorder -- thought of as being hypochondriacs -- are worried
about having a physical illness. The symptoms they describe can range from general
complaints, such as pain or tiredness to concerns about normal body functions, such as
breathing or stomach noises. People with somatic symptom disorder are not faking or lying
about their symptoms; they truly believe they are sick. Or, if they do have an actual physical
illness, their level of worry and distress is out of proportion to the condition.
Warning signs that a person might have somatic symptom disorder include:

 The person has a history of going to many doctors. They may even "shop around" for a
doctor who will agree that they have a serious illness.
 The person recently experienced a loss or stressful event.
 The person is overly concerned about a specific organ or body system, such as
the heart or the digestive system.
 The person's symptoms or area of concern might shift or change.
 A doctor's reassurance does not calm the person's fears; they believe the doctor is
wrong or made a mistake.
 The person's concern about illness interferes with their work, family, and social life.
 The person may suffer from anxiety, nervousness, and/or depression.

What Causes Somatic Symptom Disorder?

The exact cause of somatic symptom disorder is not known. Factors that might be involved in
the development of the disorder include:

 A history of physical or sexual abuse

 A history of having a serious illness as a child
 A poor ability to express emotions
 A parent or close relative with the disorder; children might learn this behavior if a
parent is overly concerned about disease and/or overreacts to even minor illnesses
 An inherited susceptibility for the disorder

How Is Somatic Symptom Disorder Diagnosed?

Diagnosing somatic symptom disorder can be very difficult, because people with the
disorder are convinced their symptoms and feelings of distress are explainable by a
medical illness."

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When symptoms appear, the doctor will begin their evaluation with a complete history
and physical exam. If the doctor finds no physical reason for the symptoms, they might
refer the person to a psychiatrist or psychologist, health care professionals who are
specially trained to diagnose and treat mental illnesses. The psychiatrist or psychologist
makes a diagnosis based on their assessment of the person's attitude and behavior, and
the fact that physical illness has been ruled out as the cause of the symptoms. The
psychiatrist or psychologist may administer a personality assessment to confirm the
diagnosis of somatic symptom disorder.

How Is Somatic Symptom Disorder Treated?

A main goal of somatic symptom disorder treatment is to help patients live and function as
normally as possible, even if they continue to have symptoms. Treatment also aims to alter
the thinking and behavior that leads to the symptoms.
The disorder can be very difficult to treat. This is due, in part, to the fact that people who have
it refuse to believe their symptoms and distress are the result of mental or emotional rather
than physical causes.
Treatment for somatic symptom disorder most often includes a combination of the following
options:

 Supportive care: In most cases, the best course of action is for the person to stay in
regular contact with a trusted health care provider. Within this doctor-patient
relationship, the doctor can monitor the symptoms and stay alert to any changes that
might signal a real medical illness. The doctor's main approach is likely to focus on
reassuring and supporting the person, and preventing unnecessary tests and
treatments. It might be necessary, however, to treat some of the symptoms, such as
severe pain.
 Medications: Antidepressant or anti-anxiety drugs are sometimes used if a person
with somatic symptom disorder also has a mood disorder or anxiety disorder.
 Psychotherapy: Psychotherapy (a type of counseling), particularly cognitive therapy,
can be helpful in changing the thinking and behavior that contribute to the symptoms.
Therapy also can help the person learn better ways to deal with stress, and improve
their social and work functioning. Unfortunately, most people with somatic symptom
disorder deny there are any mental or emotional problems, making them fairly
resistant to psychotherapy.