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Mind and Body Interplay stress association

Psychosomatic Illness

It is a condition of dysfunction or structural damage in bodily organs through inappropriate activation of the involuntary (Autonomic) nervous system and glands of internal secretion.

Psychosomatic Illness

A disorder that involves both mind and body is called a psychosomatic illness. In other words, the illness may be emotional or mental in origin but have physical symptoms. Psychosomatic illnesses are not imaginary. They are physical disorders in which both emotions and thought patterns are believed to play a central role, and usually develop when a person’s disease-fighting ability is weakened due to stress. After a particularly stressful event, like the loss of a loved one, for example, an individual might develop high blood pressure shortly afterward or even have a heart attack. In another person, the same situation might lead to a peptic ulcer or a series of asthma attacks. A third individual, equally as grief-stricken, might not get sick at all. For a psychosomatic illness to occur, a person must first be vulnerable in a particular body system. It’s important for these illnesses to be recognized and treated as soon as they occur.


Mental conditions either can cause or can make the physical illness worse.

Psycho- Physiological disorders.

  • Skin disorders  ( Eczema, skin pigmentation, etc)
  • Musculoskeletal disorders ( Aches and pains, etc)
  • Respiratory disorders ( Asthma, Atopy, Etc)
  • Cardiovascular disorders (Heart condition, etc)
  • Genitourinary disorders ( frequency, urgency, etc)
  • Endocrine disorders ( Thyroid, Diabetes, etc)
  • Disorders of organ of special sense – Chronic conjunctivitis
  • Disorder of other types – Disturbances in the nervous system in which emotional factors play a significant role, such as multiple sclerosis


It is  “Unrealistic preoccupation with a fear or believe (non delusional) of having a serious disease based on the individual interpretation of physical signs or sensations as evidenced by the physical illness. In addition appropriate physical evaluation does not support the diagnosis of any physical disorder which can account for the physical signs or sensations or for the individual’s unrealistic interpretation of them. The fear of having, or belief that one has a disease, persists despite sufficient explanation and medical reassurance.”

It Occurs between age 20-30 and affect both sex equally and Diagnostic Criteria require it should last for  6 months

Somatoform Disorders.

List of Somatoform   Disorders

Somatoform Disorder

Short Description

Somatization   Disorder Somatization   disorder is a chronic condition in which there are numerous physical   complaints that are caused by psychological problems and for which no   underlying physical problem can be identified.
Conversion   Disorder Conversion   disorder is a psychiatric condition in which emotional distress or   unconscious conflict are expressed through physical symptoms.
Undifferentiated   Somatoform Disorder Somatoform   Disorders are those conditions that are suggestive of a physical disorder but   upon examination cannot be accounted for by a medical disorder, a substance   or other mental disorder.
Hypochondriasis Hypochondriasis   is characterized by severe anxiety over the possibility of having a disease.
Pain   Disorder A   disorder in which pain in one or more anatomic sites is exclusively or predominantly   caused by psychologic factors, is the main focus of the patient’s attention,   and results in significant distress and dysfunction.
Somatoform   Disorder NOS Somatoform   Disorder Not Otherwise Specified NOS is used for patients that have symptoms   that are suggestive of somatoform disorder but do not meet the specific   diagnostic criteria for one of the disorders, have a symptom not covered in   one of the disorders, or have not met the 6-month criteria.
Body   Dysmorphic Disorder Body   Dysmorphic Disorder (BDD) is a mental disorder defined as a preoccupation   with a perceived defect in one’s appearance.

Classification of Somatoform disorder and dissociative disorders

Differentiating points between Somatizations disorder and Physical illness

1-    Involvement of multiple organ systems

2-    Early onset and chronic course without development of physical signs and structural abnormalities.

3-    Absence of Characteristic Laboratory abnormalities of the suggested physical disorder.

  • Describe symptoms in dramatic and emotional terms
  • Seek care from more than one physician at the same time
  • Describe symptoms in vague terms
  • Lack signs of defined medical illness
  • Have complaints that medical tests fail to support

People with somatization disorder do get diagnosable medical illness too It is very important to  R/O Actual physical disorder.


To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Life    event

Life    change units

Death of a spouse 100
Divorce 73
Marital separation 65
Imprisonment 63
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Dismissal from work 47
Marital reconciliation 45
Retirement 45
Change in health of family member 44
Pregnancy 40
Sexual difficulties 39
Gain a new family member 39
Business readjustment 39
Change in financial state 38
Death of a close friend 37
Change to different line of work 36
Change in frequency of arguments 35
Major mortgage 32
Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Child leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Spouse starts or stops work 26
Begin or end school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in working hours or   conditions 20
Change in residence 20
Change in schools 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Minor mortgage or loan 17
Change in sleeping habits 16
Change in number of family   reunions 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violation of law 11

Score of 300+: At risk of illness.

Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).

Score of 150-: Only have a slight risk of illness.


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