SOMATIC DISORDERS

DISORDER CLINICAL DESCRIPTION DIAGNOSIS ONSET TREATMENT

Atleast one somatic symptom is present, Patients with this disorder usually resit
Symptoms that are experienced in the body,
but the diagnosis is not sufficient without psychiatric treatment. The treatment takes
such as physical sensations (mostly pain),
an evident medical explanation. However, place in a medical setting and focuses on
movements or experiences;
the symptoms may not be associated with stress reduction and education in coping with
another medical condition (ex. Becoming chronic illness.
Excessive thoughts, feelings, or behaviors
seriously disabled after a surgery even
related to the somatic symptoms or
though disability is not a result of post- Group Psychotherapy provides the social
associated health concerns as manifested by
1. Somatic Symptom surgery) support and social interaction that seem to
at least one of the following:
Disorder reduce their anxiety.
Any one somatic symptom may not be
1. Disproportionate and persistent thoughts
continuously present, the state of being Individual Insight-Oriented Psychotherapy,
about the seriousness of one’s symptoms.
symptomatic is persistent (typically more Behavior Therapy, Cognitive Therapy, and
2. Persistently high level of anxiety about
than 6 months). Hypnosis may be useful
health or symptoms.
3. Excessive time and energy devoted to
Specify if: Persistent, with predominant Scheduled physical examination helps to
these symptoms or health concerns.
pain, and severity reassure patients that their physicians are not
A. Preoccupation with having or acquiring a abandoning them
serious illness.
Pharmacotherapy
B. Somatic symptoms are not present or, if
present, are only mild in intensity. If another
medical condition is present or there is a high
risk for developing a medical condition (e.g.,
Illness preoccupation has been present for
strong family history is present), the
at least 6 months, but the specific illness
preoccupation is clearly excessive or
that is feared may change over that period
2. Illness Anxiety disproportionate.
of time. Early and middle adulthood
Disorder
C. There is a high level of anxiety about
Specify whether: care-seeking type, or
health, and the individual is easily alarmed
care- avoidant type
about personal health status.

D. The individual performs excessive health-

related behaviors (e.g., repeatedly checks
his or her body for signs of illness) or exhibits
maladaptive avoidance (e.g., avoids doctor
appointments and hospitals).
3. Conversion Disorder
(Functional Neurological Altered voluntary motor or sensory function
Symptom Disorder)
There must be clinical findings that show Insight-oriented therapy and Psychoanalysis
clear evidence of incompatibility with explore intrapsychic conflicts and the
neurological disease symbolism of conversion disorder symptoms
Onset may be associated with
Specify symptom type: with Behavior Therapy
stress or trauma
weakness/paralysis, abnormal movement,
swallowing symptoms, speech symptom, The most important feature of the therapy is a
attack/seizures, anesthesia/sensory loss, relationship with a caring and confident
special sensory symptom, mixed; if acute therapist

Presence of one or more clinically significant
psychological/ behavioral factors that
adversely affect a medical condition by
increasing the risk for suffering, death, or
disability:
1. The factors have influenced the course of
the medical condition as shown by a close
temporal association between
4. Psychological Factors
psychological factors and the development or
Affecting Other Medical
exacerbation of, or delayed recovery from,
Conditions
the medical condition.
2. The factors interfere with the treatment of
the medical condition (e.g., poor adherence).
3. The factors constitute additional well-
established health risks for the individual.
4. The factors influence the underlying
pathophysiology, precipitating
exacerbating symptoms or necessitating
medical attention.
episode (< 6 months), Persistent (>6
months); if with/without psychological
stressor
Specify current severity:
Mild: increases medical risk
the
Moderate: Aggravates underlying
medical condition
Severe: Results in medical hospitalization
or emergency room visit
Extreme: Results in severe, life-
threatening risk
or
Psychotherapy will focus on issues of stress
and coping. Telling patients that their
symptoms are imaginary often makes them
worse
Hypnosis, anxiolytics, and behavioral
relaxation exercises are effective in some
cases
Brief and direct forms of short-term
psychotherapy have also been used to treat
this disorder. The longer the duration of these
patients’ sick role and the more they have
regressed, the more difficult the treatment
Pharmacotherapy
The major goal is to mobilize the patient to
change behavior in ways that optimize the
process of healing. This may require a general
change in lifestyle of a more specific
behavioral change
Stress Management and Relaxation Therapy
- Cognitive-behavioral therapy helps
individuals better manage their
responses to stressful life events.
- The three aims are (1) to help
individuals become more aware of
their own cognitive appraisals of
stressful events; (2) to educate
individuals about how their appraisals
Can occur across lifespan of stressful events can influence
negative emotional and behavioral
responses and to help them
reconceptualise their abilities to alter
these appraisals; (3) to teach
individuals how to develop and
maintain the use of a variety of
effective cognitive and behavioral
stress management skills
Stress Management Training
- Self- observation
- Cognitive restructuring
- Relaxation exercises
- Time management
- Problem- solving
 Factitious Disorder Imposed on Self
A. Falsification of physical or
psychological signs or symptoms, or
induction of injury or disease, associated
with identified deception.
B. The individual presents himself or
herself to others as ill, impaired, or injured.
C. The deceptive behavior is evident even
in the absence of obvious external rewards.
D. The behavior is not better explained by
another mental disorder, such as delusional
disorder or another psychotic disorder.
Factitious Disorder Imposed on Another
A. Falsification of physical or
The falsification of medical or
psychological signs or symptoms, or
5. Factitious Disorder psychological signs and symptoms in
induction of injury or disease, in another,
oneself or others
associated with identified deception.
B. The individual presents another
individual (victim) to others as ill,
impaired, or injured.
C. The deceptive behavior is evident even
in the absence of obvious external rewards.
D. The behavior is not better explained by
another mental disorder, such as delusional
disorder or another psychotic disorder.
Note: The perpetrator, not the victim,
receives this diagnosis.
Specify:
Single episode
Recurrent episodes (>2)
6. Other Somatic
Other Specified Somatic Symptom and Related Disorder; Unspecified Somatic Symptom and Related Disorder
Disorders
Onset is usually in early
adulthood, often after
hospitalization for a medical
condition or a mental disorder
No specific treatment has been effective in
treating Factitious Disorder. Treatment is best
focused on management rather than on cure
1. To reduce the risk of morbidity and
mortality
2. To address the underlying emotional needs
or psychiatric diagnosis underlying factitious
illness behavior
3. To be mindful of legal and ethical issues
Clinicians who find themselves involved with
patients with factitious disorder may become
angry at patients for lying and deceiving
them. Hence, therapist must be mindful of
countertransference whenever they suspect
factitious disorder
Legal Intervention
- The senselessness of the disorder and
the denial of false action by parents are
obstacles to successful court action and
often make conclusive proof
unobtainable
Pharmacotherapy is of limited use