Somatoform disorders

What is somatisation? 

When physical symptoms are caused by mental or emotional factors it is called somatisation.

e.g many people have occasional headaches caused by mental stress. But, stress and other mental health problems can cause many other physical symptoms.

 For example: chest pains, tiredness, dizziness, back pain, feeling sick, etc. 

How common is somatisation?

It is common. Sometimes we can relate the physical symptoms to a recent stress or mental health problem. For example, you may realise that a bout of neck pain or headache is due to stress. Anxiety and depression are also common reasons to develop physical symptoms such as palpitations, aches and pains, etc. Often the physical symptoms go when emotional and mental factors ease. However, often we do not realise the physical symptom is due to a mental factor. We may think we have a physical disease and see a doctor about it.

Somatisation and functional symptoms

Some doctors prefer to use the term functional when no known physical cause can be found for a physical symptom. A functional symptom means: a function of the body is faulty (for example, there may be pain or diarrhoea), but we dont know the cause. The cause may be due to mental factors (somatisation), physical factors not yet discovered, or a combination of both. Another term which is sometimes used for such symptoms is medically unexplained 

 Somatoform disorder and its Types

Somatoform disorder is characterized by one or more symptoms of a physical dysfunction but for which there is no identifiable organic cause.

 Following are two examples (from seven in the DSM-IV).

• A conversion disorder is a condition manifested by a physical dysfunction (blindness, deafness, paralysis, numbness, etc.) that has no underlying organic basis. This condition (formerly called hysteria) allows escape from an anxiety-provoking activity. For example, an athlete who dreads competing in an event, might develop a numb arm and effectively avoid the event.
• Hypochondriasis is characterized by a continuing belief that one has one or more serious illnesses although no medical evidence supports the belief. An occasional headache, for example, may be interpreted by a hypochondriac as a brain tumor even though medical tests do not support this interpretation.

  
  

  Causes of somatofom Disorders

  
  

  It is not clear why some people develop somatoform disorders. Genetic and environmental factors both probably play a part. That is, your genetic make-up combined with factors such as how you were brought up, your parental and peer influences, etc, may all contribute.

  
  

  
  Somatoform disorders are more common in people who abuse alcohol and drugs. However, drugs and alcohol may be factors in both cause and effect. For example, some people may turn to alcohol or other drugs to ease the distress of their somatic symptoms. On the other hand, excess alcohol or illicit drugs may make the symptoms worse.

  Treatment for somatoform disorders?

  
  

  Treatment is often difficult as people with somatisation disorders commonly do not accept that their symptoms are due to mental factors. 

  Many people who are thought to have a somatoform disorder also have other mental health problems such as depression, anxiety or substance abuse. Treatment of these other mental health problems may improve the situation.
  
  If the person can be convinced that mental (psychological) factors may contribute to, or cause, the physical symptoms then they may accept a talking treatment such as cognitive behavioural therapy. Talking treatments may help people to understand the reasons behind symptoms, aim to change any false beliefs that they may have, and help them to identify and deal with emotional issues.
  
  Medication does not have much of a role except in body dysmorphic disorder. Studies have shown that medicines called selective serotonin reuptake inhibitors (SSRIs) can ease symptoms in many people with body dysmorphic disorder. See separate leaflet called 'Body Dysmorphic Disorder' for details. SSRIs are sometimes useful in pain disorder too.