Somatoform disorder

Somatoform disorders are characterised by multiple somatic complaints^[1] or physical symptoms such as pain, nausea, depression, dizziness. Somatoform disorders are physical symptoms which present as part of a general medical condition. However, no general medical condition, other mental disorder, or substance is adequately diagnosed. The complaints are serious enough to cause significant emotional distress and impairment of social and/or occupational functioning. An inadequate diagnosis might be the result of inconclusive or faulty test results or in some cases intentional malpractice in which a caregiver deliberately mishandles a patient's health care to derive some benefit. (See munchausen syndrome by proxy.)

A diagnosis of a somatoform disorder implies that psychological factors are a large contributor to the symptoms' onset, severity and duration. It is important to note that somatoform disorders are not the result of conscious malingering or factitious disorders.

Recognized somatoform disorders

The somatoform disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association are:

• Conversion disorder
• Somatization disorder
• Hypochondriasis
• Body dysmorphic disorder
• Pain disorder
• Undifferentiated somatoform disorder - only one unexplained symptom is required for at least 6 months
• Somatoform disorder NOS

Proposed somatoform disorders

Additional proposed somatoform disorders are:

• Abridged somatization disorder^[2] - at least 4 unexplained somatic complaints in men and 6 in women
• Multisomatoform disorder^[3] - at least 3 unexplained somatic complaints from the PRIME-MD scale for at least 2 years of active symptoms

These disorders have been proposed because the recognized somatoform disorders are either too restrictive or too broad. In a study of 119 primary care patients, the following prevalences were found^[4]:

• Somatization disorder - 1%
• Abridged somatization disorder - 6%
• Multisomatoform disorder - 24%
• Undifferentiated somatoform disorder - 79%

References

1. ^ Somatoform Disorders [1]
2. ^ Escobar JI, Rubio-Stipec M, Canino G, Karno M (1989). "Somatic symptom index (SSI): a new and abridged somatization construct. Prevalence and epidemiological correlates in two large community samples". J. Nerv. Ment. Dis. 177 (3): 140-6. PMID 2918297.
3. ^ Kroenke K, Spitzer RL, deGruy FV, et al (1997). "Multisomatoform disorder. An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care". Arch. Gen. Psychiatry 54 (4): 352-8. PMID 9107152.
4. ^ Lynch DJ, McGrady A, Nagel R, Zsembik C (1999). "Somatization in Family Practice: Comparing 5 Methods of Classification" 1 (3): 85-89. PMID 15014690.

See also

• Medically unexplained physical symptoms