Somatoform Disorders
Tae Ho Ryu
I. Definition
•presence of physical symptoms in the absence of
organic pathology or known physiological mechanisms
and strong presumption of a psychological component
to the symptom.
•You feel pain without any symptom.
+ Classification is due to difference in clinical
utility, not in etiology (reason of disorders)
•Somatoform disorders had been conducted with adults,
and little information is available on children.
Don’t worry, you’re not in
Somatoform Disorders
•To be definitely diagnosed with somatoform disorder
A. At least 2 years of physical symptoms
without enough explanation for those is
needed
B. Refusal to accept doctors’ reassuarance
and advice that there is not adequate
explanation for the physical symptoms.
C. Some degree of social and family
impairment due to resulting behaviors of
disorders.
1. Somatization disorder
A. Physical complaints begin before age of 30 and must result in impairment in
important areas of life. (such as social and family)
B. Each of following must have been met
4 pain symptoms : a history of pain related to at least four different
sites or functions
2 gastrointestinal symptoms : a history of at least two gastroin
1 sexual symptom: a history of at least one sexual or reproductive
symptom other than pain
1 pseudo neurological symptom: a history of at least one symptom or
deficit suggesting a neurological condition not limited to pain
2. Undifferentiated Somatoform
disorder
A. One or more physical complaints
B. Either (1) or (2)
(1) after appropriate investigation, the symptoms cannot be
fully explained by a known general medical condition or
the direct effects of a substance (e.g., a drug of abuse, a
medication)
(2) when there is a related general medical condition, the
physical complaints or resulting social or occupational
impairment is in excess of what would be expected from
the history, physical examination, or laboratory findings
C. The symptoms cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
D. The duration of the disturbance is at least 6 months.
E. The disturbance is not better accounted for by another mental
disorder.
F. The symptom is not intentionally produced or feigned
3. Conversion disorder
A. One or more symptoms or deficits affecting voluntary motor or sensory function
that suggest a neurological or other general medical condition
B. Psychological factors are judged to be associated with the symptom or deficit
because the initiation or exacerbation of the symptom or deficit is preceded by
conflicts or other stressors.
C. The symptom or deficit is not intentionally produced or feigned
D. The symptom or deficit cannot, after appropriate investigation, be fully explained
by a general medical condition, or by the direct effects of a substance, or as a
culturally sanctioned behavior or experience.
E. The symptom or deficit causes clinically significant distress or impairment in
social, occupational, or other important areas of functioning or warrants medical
evaluation.
F. The symptom or deficit is not limited to pain or sexual dysfunction, does not occur
exclusively during the course of somatization disorder, and is not better accounted
for by another mental disorder
4. Pain Disorder
A. Pain in one or more anatomical sites is the predominant focus
of the clinical presentation and is of sufficient severity to
warrant clinical attention.
B. The pain causes clinically significant distress or impairment
in social, occupational, or other important areas of
functioning.
C. Psychological factors are judged to have an important role in
the onset, severity, exacerbation, or maintenance of the pain.
D. The symptom or deficit is not intentionally produced or
feigned (as in factitious disorder or malingering)
E. The pain is not better accounted for by a mood, anxiety, or
psychotic disorder and does not meet criteria for dyspareunia.
5. Hypochondriasis
A. Preoccupation with fears of having, or the idea that one has, a serious
disease based on the person’s misinterpretation of bodily symptoms
B. The preoccupation persists despite appropriate medical evaluation and
reassurance.
C. The belief in Criterian A is not of delusional intensity (like delusional
disorder) and is not restricted to a circumscribed concern about appearance.
(like body dysmorphic disorder)
D. The preoccupation causes clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
E. The duration of the disturbance is at least 6 months.
F. The preoccupation is not better accounted for by Generalized Anxiety
Disorder, Obssessive-Compulsive Disorder, Panic Disorder, A Major
Depressive Episode, Separation Anxiety, or another Somatoform Disorder.
6.Body Dysmorphic Disorder (BDD)
A. Preoccupation with an imagined defect in appearance. If a
slight physical anomaly is present, the person’s concern is
markedly excessive.
B. The preoccupation causes clinically significant distress or
impairment in social, occupational, or other important areas
of functioning.
C. The preoccupation is not better accounted for by another
mental disorder (e.g., dissatisfaction with body shape and size
in anorexia nervosa)
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The reason for Somatoform disorders are still
unclear. The psychologists argue that the
reasons are mostly seem to be from somatic
amplifications, but this is only one of many
factors that have received inconsistent
support.
Prevention : Difficult
◦ Because it is shown in different age.
III Statistics (1)
•Somatization Disorder:
•Male: less than 0.2%
•Female: 0.2% to 2%
•More in Africa and South Asia than in North America
•About 0.1% in total
•Undifferentiated Somatoform Disorder:
•Highest frequency of unexplained physical complaints occurs in
young women of low socioeconomic status.
•Conversion Disorder
•Ranging from 11/100,000 to 500/100,000 (0.011% to 0.5%)
•Low socioeconomic status is more frequently reported to have this
•More frequent in women than in men, with reported ratios varying
from 2:1 to 10:1
•Pain Disorder
•10~15% of adults in the U.S. have some form of work disability due
to back pain, but the prevalence of Pain Disorder itself is unclear.
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Leonardo Di Caprio
Conversion
disorder
He thought that the
roadblocks will harm him
that he couldn’t go out for
a while.
This happened when he was
making film called,
“Aviator”
Conversion Disorder
Leonardo Dicaprio
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Michael Jackson
BDD
a condition that often
paralyzes its sufferers with
shame, embarrassment,
and even disgust.
He decreased the frequency
of concert due to BDD.
BDD
Michael Jackson
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DiCaprio suffers from Compulsive Disorder.
(2013, November 10). DiCaprio suffers from
Compulsive Disorder. Retrieved November 10,
2013, from
http://www.femalefirst.co.uk/celebrity/Leona
rdo+DiCaprio-1662.html
Dr. Anand Balan | Psychiatrist in Chennai.
(n.d.). Dr. Anand Balan | Psychiatrist in
Chennai. Retrieved November 10, 2013, from
http://www.anandbalan.in/somadis.html
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Diagnostic and statistical manual of mental
disorders: DSM-IV-TR. (4th ed.). (2000).
Washington, DC: American Psychiatric
Association.
Mash, E. J., & Barkley, R. A. (2003). Child
psychopathology (2nd ed.). New York: Gilford
Press.
VandenBos, G. R. (2007). APA dictionary of
psychology. Washington, DC: American
Psychological Association.