S O M AT I C

SYMPTOM
ILLNESSES
• Group of illnesses where bodily signs and
symptoms are a major focus
• the symptoms are medically unexplained
• several terms were used like Hysteria,
Neurasthenia
• more common in Women
 HYSTERIA
• Refers to multiple physical complaints with no organic
basis
• the complaints are usually described dramatically
• Freud propose that people can convert unexpressed
emotions into physical symptoms and now known as
SOMATIZATION
 S O M AT I Z AT I O N
• is defined as the transference of mental experiences
and states into bodily symptoms
• characterized as the presence of physical symptoms
that suggests a medical condition without demonstrable
organic basis
 • Central Features :
• Physical complaints suggest major medical
illness but have no demonstrable organic basis
• Psychological factors and conflicts seem
important in initiating, exacerbating and
maintaining the symptoms
• Symptoms or magnified health concerns are not
under the client’s conscious control
 S O M AT I C S Y M P T O M
DISORDERSINCLUDE:
• Somatic symptom disorder – characterized by one or
more physical symptoms that have no organic basis
• spend a lot of time and energy focused on health
concerns, often believe symptoms indicative of of
serious illness and often experience distress and
anxiety about their health
• Functional neurological symptom disorder –
( formerly conversion reaction)
• sudden deficit in sensory or motor function (ex.
Blindness, paralysis)
• these deficit suggest a neurologic disorder but are
associated with psychological factors
• there is significant functional impairment
•
• Pain disorder – primary physical symptoms of pain
• not relieved by analgesics and greatly affected by
psychological factors of onset, severity
• Illness anxiety (formerly Hypochondriasis) – pre
occupation with the fear that one has a serious d
 ONSET AND CLINICAL COURSE
• EXPERIENCE in adolescence but diagnoses is made
until early adulthood 25y/o
• clients tend to go from one physician, clinic to another
• they tend to be pessimistic about the medical
establishment and often believe their disease could be
diagnosed if providers were more competent
 R E L AT E D D I S O R D E R S
• Somatic illnesses need to be distinguished from other
body – related mental disorders such as Malingering
which is also known as ( Fabricated or induced
illnesses) – people intentionally produce symptoms for
some purpose of gain
• people usually control their symptoms, whereas in
somatic they do voluntarily their physical symptoms
• Malingering – intentional production of
false or exaggerated physical or
psychological symptoms
• usually motivated to avoid work, evade
criminal prosecution, obtaining financial
compensation
• they do not have real physical symptoms
• Factitious disorder, imposed on self – person
intentionally produces physical or psychological symptoms
solely to gain attention
• they may even inflict injury on themselves to receive
attention
• Munchausen syndrome –factitious disorder imposed on
self
• Munchausen syndrome by proxy – person inflicts pain
or injury on someone else to gain attention or to be a hero
in saving the victim
• Medically unexplained symptoms and functional
somatic symptoms – physical symptoms and
limitations of functions that have no medical diagnoses
to explain their existence
 ETIOLOGY
• People with somatic symptom illness keep stress,
anxiety, anxiety or frustration rather than expressing
them outwardly –this is called INTERNALIZATION
• Causes
• The exact cause of somatic symptom disorder isn't clear, but any of
these factors may play a role:
• Genetic and biological factors, such as an increased sensitivity to pain
• Family influence, which may be genetic or environmental, or both
• Personality trait of negativity, which can impact how you identify and
perceive illness and bodily symptoms
• Decreased awareness of or problems processing emotions, causing
physical symptoms to become the focus rather than the emotional
issues
• Learned behavior — for example, the attention or other benefits gained
from having an illness; or "pain behaviors" in response to symptoms,
such as excessive avoidance of activity, which can increase your level
of disability
• Treatment
• The goal of treatment is to improve your symptoms
and your ability to function in daily life.
Psychotherapy, also called talk therapy, can be helpful
for somatic symptom disorder. Sometimes
medications may be added, especially if you're
struggling with feeling depressed.
• Psychotherapy
• Because physical symptoms can be related to
psychological distress and a high level of health
anxiety, psychotherapy — specifically, cognitive
behavioral therapy (CBT) — can help improve
physical symptoms.
• CBT can help you:
• Examine and adapt your beliefs and expectations about health and physical symptoms
• Learn how to reduce stress
• Learn how to cope with physical symptoms
• Reduce preoccupation with symptoms
• Reduce avoidance of situations and activities due to uncomfortable physical sensations
• Improve daily functioning at home, at work, in relationships and in social situations
• Address depression and other mental health disorders
• Family therapy may also be helpful by examining family relationships and improving family
support and functioning.
• Medications
• Antidepressant medication can help reduce symptoms associated with
depression and pain that often occur with somatic symptom disorder.

• If one medication doesn't work well for you, your doctor may
recommend switching to another or combining certain medications to
boost effectiveness. Keep in mind that it can take several weeks after
first starting a medication to notice an improvement in symptoms.
• Antidepressants:
• Fluoxetine (Prozac) 20-60
• Monitor for rash, hives, headache, insomnia, nausea,
loss of appetite,avoid alcohol
• Sertraline (Zoloft) – 50-200
 HOME REMEDIES
• Work with your care providers. Work with your medical care provider
and mental health professional to determine a regular schedule for
visits to discuss your concerns and build a trusting relationship. Also
discuss setting reasonable limits on tests, evaluations and specialist
referrals. Avoid seeking advice from multiple doctors or emergency
room visits that can make your care more difficult to coordinate and
may subject you to duplicate testing.
• Practice stress management and relaxation techniques.
Learning stress management and relaxation techniques, such
as progressive muscle relaxation, may help improve
symptoms.
• Get physically active. A graduated activity program may
have a calming effect on your mood, improve your physical
symptoms and help improve your physical function.
• Participate in activities. Stay involved in your work
and in social and family activities. Don't wait until
your symptoms are resolved to participate.
• Avoid alcohol and recreational drugs. Substance use
can make your care more difficult. Talk to your health
care provider if you need help quitting.