SOMATIC SYMPTOM DISORDER

 

Somatic symptom disorder happens when a person feels significantly distressed about physical symptoms and has abnormal feelings and behaviors in response to them. These responses interfere with their daily functioning. The physical symptoms may be due to a medical condition or have no clear cause.

Somatic symptom and related disorders is the name for a group of conditions in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms canít be traced to a specific physical cause. In people who have a somatic symptom and related disorders, medical test results are either normal or donít explain the personís symptoms.

People who have this disorder may have several medical evaluations and tests to be sure that they donít have another illness. They often become very worried about their health because they donít know whatís causing their health problems. Their symptoms are similar to the symptoms of other illnesses and may last for several years. People who have a somatoform disorder are not faking their symptoms. The pain that they feel is real.

For a diagnosis of SSD, the negative thoughts and emotions must last for at least 6 months and cause one or more of the following symptoms:

In the DSM-V, SSD replaced other mental health conditions, including:

One key differentiation between SSD and the above former DSM-IV disorders is that people with SSD do not need to experience unexplainable symptoms.

Another difference from the former conditions is that SSD causes at least one chronic physical symptom. Additionally, it accompanies excessive, persistent negative feelings, thoughts, and emotions.

Difference between somatic symptom disorder and illness anxiety disorder

Illness anxiety disorder (formerly called Hypochondriasis) is a mental health condition in which a person is preoccupied and excessively worried about having an illness or getting an illness. Unlike somatic symptom disorder, a person with illness anxiety disorder usually doesnít experience physical symptoms.

 

There are several types of somatic symptom and related disorders.

Somatization disorder usually involves pain and severe neurological symptoms (such as headache, fatigue). Other symptoms include:

Digestive symptoms (such as nausea, vomiting, abdominal pain, constipation, and diarrhea).

Sexual symptoms (such as pain during sexual activity, loss of sexual desire, and extremely painful periods in women).

Hypochondriasis occurs when a person believes that normal body functions (such as a grumbling stomach) or minor symptoms (such as a common headache) are symptoms of a very serious disorder. To a person who has hypochondriasis, a grumbling stomach may mean stomach cancer. A headache may mean a brain tumor.

Body dysmorphic disorder occurs when a person becomes obsessed with a flaw in his or her physical appearance. The flaw is either a minor flaw or a flaw that doesnít exist. He or she constantly worries about the perceived flaw, which can be any part of the body. Common concerns for people who have body dysmorphic disorder include:

wrinkles

hair loss

weight gain

size and shape of feature like the eyes, nose, and breasts

Conversion disorder (also called Functional Neurological Symptom Disorder) is when physical symptoms that are similar to a neurological disorder develop even though no neurological disorder is actually present. Common symptoms include:

paralysis of an arm or leg

vision loss

hearing loss

seizure

Stress may make the symptoms worse.

Signs and symptoms of somatic symptom disorder

Physical symptoms that people with SSD may have include:

The physical symptoms may be mild to severe, and there may be one or multiple symptoms. They may be due to a medical condition or have no clear cause.

How people think, feel and behave in response to these physical symptoms are the main signs of somatic symptom disorder. People with SSD may:

Characteristics of Somatoform Disorders

 

Disorder

Essential characteristics

Somatization disorder

Unexplained physical symptoms manifested before age 30

Symptoms last for several years

Symptoms include two gastrointestinal, four pain, one pseudoneurologic, and one sexual

Undifferentiated somatoform disorder

≥ Six months' history

One or more unexplained physical symptoms

Conversion disorder

Single unexplained symptom involving voluntary or sensory functioning

Pain disorder

Pain symptom is predominant focus

Psychological factors play the primary role in the perception, onset, severity, exacerbation, or maintenance of pain

Hypochondriasis

Fixation on the fear of having a life-threatening medical condition

Body dysmorphic disorder

Preoccupation with a real or imagined physical defect

Somatoform disorder not otherwise specified

Misinterpretation or exaggeration of unexplained physical symptoms

Patient does not meet full criteria for any of the other somatoform disorders

 

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 ó 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