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.
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
List of Somatoform Disorders
|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 change units
|Death of a spouse||100|
|Death of a close family member||63|
|Personal injury or illness||53|
|Dismissal from work||47|
|Change in health of family member||44|
|Gain a new family member||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|
|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|
|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.