Psychosomatic disorders

Overview and management

etc. tiredness. What is somatisation? When physical symptoms are caused by mental or emotional factors it is called somatisation. dizziness. feeling sick. many people have occasional headaches caused by mental stress. .What is psychosomatic illness?  Psychosomatic means mind (psyche) and body (soma). But. For example: chest pains. back pain. stress can cause many other physical symptoms. For example.

but they cannot be fully explained by depression. but no physical disease can fully explain the symptoms. People with somatoform disorders usually disagree that their symptoms are due to mental factors. body dysmorphic disorder. These are classified as separate mental health disorders as the cause of the symptoms is thought to be mental factors. pain disorder. substance abuse. the physical symptoms persist long-term. or are severe. conversion disorder.  Somatoform disorders include: somatisation disorder. or other recognised mental health disorders.What are the somatoform disorders?  The somatoform disorders are the extreme end of the scale of somatisation. hypochondriasis. and are convinced that the cause of their symptoms is a physical problem   .

or the shape or size of other body parts.Body Dysmorphic Disorder  An obsession or preoccupation with a minor or imaginary flaw. such as wrinkles. small breasts. causes severe anxiety and may impact a person’s ability to function normally in daily life  .

Symptoms can include seizures.Conversion Disorder It is a disorder in which a person experiences neurological symptoms that affect his or her movement and senses and that do not appear to have a physical cause. blindness or paralysis .

.Pain Disorder Pain disorder is a condition where a person has a persistent pain that cannot be attributed to a physical disorder.

Hypochondriasis It is an obsession or fixation with the fear of having a serious disease. a person with hypochondriasis may become convinced that he or she has colon cancer when having temporary flatulence after eating cabbage. For example. . People with hypochondriasis misconstrue normal body functions or minor symptoms as being serious or life threatening.

These symptoms. cannot be explained fully by a nonpsychiatric diagnosis. Nonetheless. . The disorder usually begins before age 30 and occurs more often in women than in   Stress often worsens the symptoms. however.Somatization disorder  A person with somatization disorder is chronically preoccupied with numerous "somatic" (physical) symptoms over many years. the symptoms cause significant distress or impair the person's ability to function.

.The cause The cause of the symptoms may be that people with this disorder perceive bodily sensations in an unusual way. Trauma or stress may cause a person's physical sensations to change.

     Pain — Including headache. paralysis. weakness. stomach ache. vomiting. back ache. joint pain and chest pain Gastrointestinal symptoms — Nausea. vision problems or seizures . Cultural factors also affect the proportions of men and women with the disorder.Symptoms of Somatization disorder Symptoms of somatization disorder vary by culture. diarrhea Sexual symptoms — Erectile dysfunction Menstrual problems — Irregular periods Neurological symptoms — Problems with coordination or balance. numbness.

Each of the following criteria must have been met. 4 pain symptoms: a history of pain related to at least 4 different sites or functions 2 gastrointestinal symptoms: a history of at least 2 gastrointestinal symptoms ther than pain 1 sexual symptom: a history of at least 1 sexual or reproductive symptom other than pain 1 pseudoneurological symptom: a history of at least 1 symptom or deficit suggesting a neurological condition not limited to pain .DSM-IV Criteria for Somatoform Disorders         History of many physical complaints beginning before age 30 years that occu over a period of several years and result in treatment being sought or significant impairment of functioning. with individual symptoms occurring at any time during the course of the disturbance.

together with a > or = 2-year history of somatisation.Multisomatoform disorder (MSD)  Multisomatoform disorder (MSD) is characterised by > or = 3 medically inexplicable. Co-morbid depressive disorders are associated with increased symptom severity and functional impairment  . troublesome physical symptoms.

even if he still has pain Therapy with antidepressants reduces symptom severity in somatoform pain disorders and multisomatoform disorder.  . patient will learn: To recognize what seems to make the pain worse  To develop methods of coping with the symptoms  To keep himself more active. Cognitive behavioral therapy (CBT)  During therapy. Having a supportive relationship with the doctor is the most important part of treatment.Goal of treatment   The goal of treatment is to control your symptoms.

Treatment of underlying neurosis in somatoform disorders  If anxiety or depression is the cause of somatization. .23(43-8 1):. Compared with placebo. 2008 Jan. escitalopram was associated with lower symptom scores.   Muller JE Escitalopram in the treatment of multisomatoform disorder: a double-blind. SSRIs like escitalopram can help 12-week. and improved functioning. increased response and remission rates. randomized. escitalopram (10-20 mg/day) was both effective and well tolerated in the treatment of patients with somatoform disorders. placebo-controlled trial Int Clin Psychopharmacol. placebo-controlled study..

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