Somatoform Disorders

Somatoform disorders represent a group of disorders characterized by physical symptoms suggesting a medical disorder. Stress and trauma lead to anxiety, but instead of developing one of the anxiety disorders or depression, some people somaticize:  They experience the anxiety as fatigue, loss of appetite, body aches, headaches, gastrointestinal problems, and so on. Somatization is actually the most common manifestation of anxiety, especially in non-western countries.

However, somatoform disorders represent a psychiatric condition because the physical symptoms present in the disorder cannot be fully explained by a medical disorder, substance use, or another mental disorder. These somatoform disorder physical complaints challenge medical providers who must distinguish between a physical and psychiatric source for the patient’s complaints. Often, the medical symptoms patients experience may be from both medical and a psychiatric illnesses. Anxiety disorders and mood disorders commonly produce physical symptoms. These physical symptoms can dramatically improve with successful treatment of the anxiety or mood disorder.

People with somatization disorder have a history of complaints concerning their physical health, yet show little or no signs of actually having the problems they think they have.  It is a rare disorder in western societies, affecting .2 to 2% of women and less than .2% of men.  These people seem to have a very broad variety of problems, including pain in different parts of the body, gastrointestinal problems, sexual difficulties and neurological problems.  It has been a concern, however, that this diagnosis has been misused in the past, especially in regards to women who may very well have had real medical conditions beyond the abilities of their doctors to diagnose.

People with pain disorder have a history of complaints specifically concerning pain.  These people are not lying, and are not malingering – they really feel pain, even though the cause is not found.  It is relatively common, but many are concerned with using this diagnosis:  There have been real medical problems discovered that had previously been “dismissed” as psychological, such as fibromyalgia.  Nevertheless, we have to be careful not to underestimate our ability to intensify or even create suffering in ourselves.  Simply focussing attention on small aches and pains can intensify them. Moverover, hypochondriasis is also, officially, a part of the somatoform disorders.