Somatoform disorders are a group of disorders in which the person reports physical complaints resembling bodily dysfunction. However, most investigations fail to reveal any actual physical defects. The five major types of somatoform disorders are namely
➔ Somatization Disorder
➔ Pain Disorder
➔ Conversion Disorder
➔ Body Dysmorphic Disorder
The terms somatization disorder, pain disorder, and undifferentiated somatoform disorder were discarded in DSM-5-TR, while factitious disorder and psychological factors affecting other medical conditions were added to somatic symptom disorder and other disorders. Conversion disorder is still classified as such in the DSM-5-TR. The term "hypochondria" has been renamed "illness anxiety disorder."
According to DSM-5-TR, the symptoms for this disorder must begin before the age of 30. There must be at least four pain symptoms in different parts of the body (for example, head, neck, back, etc.), at least two gastrointestinal symptoms (such as diarrhoea, nausea, etc.), one sexual symptom other than pain (such as erectile dysfunction, lack of desire), and one pseudo-neurological symptom (such as fainting). An adequate medical investigation must have been conducted to rule out all known organic causes of the symptoms. Somatization disorder symptoms are hazy. The individual frequently visits doctors and is hospitalised. Actual physical symptoms may occur as a result of unwarranted faulty treatment and invasive interventions, complicating the situation. Depression and anxiety may accompany the symptoms of somatization.
Pain disorder is a medical condition in which pain is the primary symptom. Other symptoms may include swelling, tightness, tenderness etc. Myofascial pain is the most common type of pain disorder, characterised by pain and tender trigger points in the skeletal muscles. This is followed by arthritis-related joint pain, disc disorders, and arthralgia. Neuropathic and neuralgic pain are common and treatable conditions. Receiving medical attention as soon as possible usually helps to prevent or mitigate problems.
There is no clear definition of a pain disorder. Some people believe they have had chronic pain their entire lives, but this isn't necessarily a chronic pain disorder unless it lasts for more than 6 months and causes significant discomfort. The pain is frequently so severe that the patient is unable to function normally. It could be as short as a few days or as long as many years.
Fear of physical disease characterises hypochondriasis. You may have met people who believe they have serious diseases such as cancer or heart problems. However, investigations reveal that there is no organic pathology present. While many of us may mistakenly interpret some bodily discomfort as a sign of something serious, the person suffering from hypochondria is quite convinced of the presence of the illness. According to the DSM-5-TR, preoccupation with the fear of contracting or having a serious illness is the main criterion of hypochondriasis. The conviction is the result of misinterpretation of a passing bodily symptom. For instance, a person may consider a sore throat to be the first sign of throat cancer.
Conversion disorder is a mental illness in which a person experiences blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained medically. Researchers are still searching for a cause, but they believe conversion disorder occurs as a way for your brain to cope with emotional stress. Upsetting situations and other mental disorders almost always set it off. Women are more likely than men to have it. It also occurs more frequently in people who have a history of emotional stress or who have difficulty talking about their feelings.
Conversion disorder symptoms usually occur unexpectedly and appear to be nervous system problems (brain, spinal cord, or other nerves). They are as follows: No control over your movements, blindness or tunnel vision, sense of smell or speech impairment, paralysis or numbness.
Body Dysmorphic Disorder
Body dysmorphic disorder is a mental health condition in which you can't stop thinking about one or more perceived flaws in your appearance — a flaw that appears minor or is invisible to others. However, you may avoid many social situations because you are embarrassed, ashamed, or anxious.
➔ Being preoccupied with a perceived flaw in one's appearance that, to others, is not visible or appears minor
➔ Strong conviction that you have a flaw in your appearance that renders you ugly or deformed
➔ Belief that others make a negative comment about your appearance or mock you
➔ Engaging in difficult-to-control behaviours aimed at fixing or concealing the perceived flaw, such as frequent mirror checking, grooming, or skin picking
➔ Frequently seeking reassurance from others about your appearance
➔ Possessing perfectionistic tendencies
➔ Using styling, makeup, or clothing to conceal perceived flaws
➔ Constantly comparing your physical appearance to that of others
➔ Looking for cosmetic procedures with little success
➔ Staying away from social situations
Treatment for Somatoform disorders
For somatoform disorders, various types of psychotherapy have been recommended. The role of cognitive behaviour therapy (CBT), mindfulness-based interventions, acceptance and commitment therapy, and relaxation therapy in the treatment of individual subtypes of somatoform disorders is supported by evidence.
Now put on your thinking hats and think about the following questions for a couple of minutes.
How would you explain the term “somatoform disorder” to your students?
Can you think of some factors that may contribute to somatoform disorders?
Can you think of ways to help a friend or relative who is suffering from somatoform disorder?
Write down your thoughts and discuss them with your students, children and your colleagues. Listen to their views and compare them with your own. As you listen to others, note how similar or different your views are to others’.
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