SOMATOFO

RM

DISORDER
Prepared by:
Joan Mae V. Basamot, RN
Kim Bryan C. Aliperio, RN

Learning Objectives:
Explain what is meant by
psychosomatic illness
Describe somatoform disorders and
their Three Central Features
Discuss the etiologic theories related
to somatoform disorders
Discuss the characteristics and
dynamics of specific somatoform
disorders

Learning Objectives:
Distinguish somatoform disorders from
malingering and factitious disorders
Discuss different nursing interventions and
health teachings related to clients with
Somatoform Disorder

Overview:
In early 1800s, the medical field began to
consider various social and psychologic
factors that influence illness.
The term psychosomatic connection
between the mind (psyche) and the body
(soma), in states of health and illness.
The term hysteria refers to multiple
physical complaints with no organic
basis. It is probably originated in Egypt
and is about 4000 years old.

 Somatoform Disorder is a diagnosis

given to individuals who present with
symptoms suggesting a physical
disorder without demonstrable organic
findings to explain the symptoms.
(American Psychiatric
Association,2000)
Individuals with somatoform disorders
will present in the medical rather than
the psychiatric setting because of their
belief that the problems are medical.

 Research has suggested that biologic and

genetic factors are responsible for the
development of certain somatoform
disorders.
Clients are convinced they harbor serious
physical problems despite negative results
during diagnostic testing.
Nurses must remember that these clients
really experience the symptoms they
describe and cannot voluntarily control
them.

Three 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 under the clients conscious control

Etiologic Theories
Psychosocial Theory

theorists believe that people with somatoform

disorders keep stress, anxiety, or frustration
inside rather than expressing them outwardly.
This is called internalization.
People with somatoform disorders do not
readily and directly express their feelings and
emotions verbally.
The worsening of physical symptoms helps
them to meet psychological needs for security,
attention, and affection through PRIMARY
GAIN and SECONDARY GAIN.

Etiologic Theories
Biologic Theory
These clients cannot sort relevant from
irrelevant stimuli and respond equally
to both types. In other words, they may
experience a normal body sensation
such as peristalsis and attach a
pathologic rather than a normal
meaning to it.

Five Specific Somatoform

Disorders

Somatization Disorder
Conversion Disorder
Pain Disorder
Hypochondriasis
Body Dysmorphic Disorder

Somatization Disorder
also known asBriquets Syndrome
A psychiatric diagnosis applied to patients who
persistently complain of varied physical symptoms
that have no identifiable physical origin.
A combination of pain, gastrointestinal, sexual,
and pseudoneurologic symptoms.
Usually begins by 30 years of age.
May be treated in mental health settings.
*Many people who have somatization disorder will also have ananxiety disorder.

Conversion Disorder

Usually sudden deficits in sensory or

motor function (e.g. blindness, paralysis).
It is believed to be the substitution of a
physical symptom for an emotional
conflict that cannot be expressed openly
(Deaton, 1998)
May display la belle indifference - a relative
lack of worry about their condition or its
implications.
Laboratory analysis of the condition
typically do not yield any findings either.
Usually occurs between 10 35 years of
age.

Pain Disorder
It has the primary physical symptom of
pain, which generally is unrelieved by
analgesics and greatly affected by
psychologic factors in terms of onset,
severity, exacerbation, and maintenance.
Often a history of real injury or illness
Avoid narcotic analgesics. May use
NSAIDs to help reduce pain.
Pain management: Visual Imaging &
Relaxation. Physical Therapy.

Hypochondriasis

Client presents with unrealistic or

exaggerated physical complaints.
Referred to as professional
patients
Preoccupation with the fear that one
has a serious disease (disease
conviction) or will get a serious
disease (disease phobia).
Test with normal results gives no
lasting satisfaction for the patient.
Usually occurs in early childhood and
usually becomes chronic.

Body Dysmorphic Disorder

Preoccupation with an imagined or
exaggerated defect in physical appearance
such as thinking ones nose is too large or
teeth are crooked or unattractive.
Usually occurs from adolescence to third
decade of life.
They can't control their negative thoughts
and don't believe people who tell them that
they look fine.
They may even undergo unnecessary plastic
surgeries to correct perceived imperfections,
never finding satisfaction with the results.

Related Disorders
Somatoform disorders need to be
distinguished from other body-related
mental disorders such as malingering
and factitious disorders in which people
feign or intentionally produce symptoms
for some purpose or gain.
MALINGERING- the intentional
production of false or grossly exaggerated
physical or psychologic symptoms.

Related Disorders

FACTITIOUS DISORDER- occurs when

a person intentionally produces or feigns
physical or psychologic symptoms solely
to gain attention
Also known as Munchausens
syndrome
A variation of factitious disorder,
Munchausens by proxy, occurs
when a person inflicts illness or
injury on someone else to gain the
attention of emergency medical
personnel or to be a hero for
saving the victim.

Treatment
Treatment focuses on managing symptoms
and improving quality of life.
Show empathy and sensitivity
For many clients, depression may accompany
or result from somatoform disorders. Thus,
antidepressants (SSRIs) help in some cases.
For clients with pain disorder, referral to a
chronic pain clinic may be useful.
Cognitive-behavioral Therapy- produced
significant improvement in clients with
somatization disorder and hypochondriasis .

Thank
You!