Somatoform Disorders

Adrianne Maltese, MN,GCNS-BC

Somatoform Disorders

Three central features of

Somatoform Disorders:
Physical

complaints without organic

basis
Psychological factors and conflicts
seem important in initiating,
exacerbating, and maintaining the
symptoms
Symptoms or magnified health
concerns are not under conscious
control(Guggenheim2000)

Five Somatoform disorders

Somatization disorder
C/b multiple recurrent physical complaints
over many years
No organic etiology for these complaints
Begins by age 30
Pain, GI, sexual, pseudoneurologic
symptoms: impaired coordination or
balance,paralysis or localized
weakness,difficulty swallowing, aphonia,
urinary retention,hallucinations, loss of
touch or pain sensation,double
vision,amnesia,sensory losses,loss of
consciousness (APA 2000 DSM IV-TR)

Interventions for somatization

Be aware of own responses

Rule out organic basis for
complaints
Focus on anxiety reduction, mot
physical symptoms
Minimize secondary gain(I.e.
increased attention and
decreased responsibilities)

Intervention conversion d/o

Focus on anxiety reduction, not

physical symptoms
Use matter-of-fact approach
Encourage client to discuss
conflict
Minimize secondary gains
Provide diversionary activities
Encourage expression of feelings

Pain Disorder

C/b physical symptom of painone or more anatomic sites

May occur with a General
medical condition
Pain not relieved by analgesics
Onset,severity, exacerbation
and maintenance affected by
psychological stressors

Pain d/o interventions

Pain management
Encourage participation in
activities
Provide distractions

Hypochondriasis

Client is preoccupied with fear that he/she

has or will get a serious disease
History of seeing many doctors
Misinterpretation of bodily sensations or
functions despite medical evaluations and
reassurance
Preoccupation with symptoms is not as
intense or distorted as in delusional
disorder
Significant distress/impairment in function
Dependent behaviors/desires,demands
attention

Hypochondriasis interventions

Rule out presence of actual

disease
Focus on anxiety, not physical
symptoms
Provide diversionary activities
Avoid negative responses to client
demands/conference with staff
Provide client with correct
information

Body Dysmorphic Disorder

Preoccupation with imagined or

exaggerated defects in physical
appearance
Causes clinically significant
stressor impairment in social or
occupational function person
may undergo repeated plastic
surgeries for nose repair or to
change face etc.

Dissociative Disorders
DISSOCIATIVE AMNESIA:
One or more episodes of
inability to recall personal
information
Information is usually of a
traumatic or stressful nature
Not due to effects of substance
abuse

Dissociative Fugue

C/b sudden unexpected travel

away from home or work
Unable to recall past(or where
on has been)
Confused about personal
identity/ or assumes new
identity

Dissociative Identity Disorder

Individual demonstrates two or

more distinct identities or
personality states
Each personality is distinct
At least two of these personality
states take control of the
individuals behavior.
Unable to recall extensive personal
information