Somatoform disorders are characterised by multiple somatic complaints 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.
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 - at least 4 unexplained somatic complaints in men and 6 in women
Multisomatoform disorder - 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:
^ 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.
^ 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. Psychiatry54 (4): 352-8. PMID 9107152.
^ Lynch DJ, McGrady A, Nagel R, Zsembik C (1999). "Somatization in Family Practice: Comparing 5 Methods of Classification" 1 (3): 85-89. PMID 15014690.