Somatoform Disorders

Sources, DSM-IV-TR, Tasman and First, and Kaplan and Sadock.

As 8July2008

General Definition

Q. What is the general definition of somatoform disorder?

General Definition

Ans. The presence of physical symptoms that suggest a general medical condition and are not fully explained by a general medial condition, by a substance, or by another mental illness.

Somatoform DisordersList

Q. List the six somatoform disorders, in addition to the NOS category.

Somatoform DisordersList

Ans.

Somatization disorder

Undifferentiated somatization disorder

Conversion disorder

Pain disorder

Hypochondriasis

Body dysmorphic disorder

Somatization Disorder

Q. Primary criteria for somatization disorder?

Somatization Disorder

Ans.

1. Begins before age 30.

2. Four pain symptoms, two GI, one sexual, and one pseudoneurological.

3. Is not explained by another disorder or, if explained, complaints are in excess of what would be expected.

Prevalence

Q. What is the prevalence?

Prevalence

Ans. Women: 0.2 to 2%

Men: <0.2%

[While much more common in women in most areas of the US, is reported to be high in Puerto Rico men – suggesting culture plays a role.]

Course

Q. What is the course?

Course

Ans. Rarely remits completely. Usually sees a physician at least once/year.

Criteria of UndifferentiatedSomatoform Disorder

Q. What is the criteria of this disorder?

Undifferentiated Somatoform Disorder

Ans.

On or more physical complaints that cannot be explained or the complaints are excessive.

Last at least 6 months.

USD Gender

Q. Gender breakdown?

USD - Gender

Ans. Women

USD - course

Q. Course?

USD - course

Ans. Unpredictable. Frequently evolves into another psychiatric or somatic disorder

Conversion Disorder

Q. Essential feature?

Essential feature of CD

Ans.

The presence of symptoms or deficits affecting voluntary motor or sensory function that suggests neurological or other general medical condition, but in actuality seems based on psychological factors.

CD subtypes

Q. What are the subtypes of conversion disorder?

CD Subtypes

Ans.

1. With motor symptom or deficit

2. With sensory symptom or deficit

3. With seizures or convulsions

4. With mixed presentations

CD prevalence

Q. Prevalence of conversion disorder. More common in urban or rural? More in men or women? Associated dx in women? Associated dx in men?

CD prevalence

Ans. Prevalence is rare to common, the latter being in rural, poor, uneducated parts of the world. More common in women, and women often have other somatoform disorders, whereas men are more likely to also have an antisocial personality disorder.

Treatment of Conversion Disorder

Q. What is the usual treatment of conversion disorder?

Treatment of Conversion Disorder

Ans. Resolution is usually spontaneous, but if not, a positive relationship with a caring and confident therapist. Focus on issues of stress and coping. Sometimes effective: Hypnosis, anxiolytics, and relaxation exercises.