Somatoform Disorders



Somatoform Disorders





Somatoform disorders: conversion disorder, somatization disorder, pain disorder, hypochondriasis, body dysmorphic disorder.

Somatizing disorders: besides somatoform disorders, also include malingering, factitious disorders, psychological factors affecting a medical condition (Table 162.1).

Physical symptoms in somatoform disorders: (a) suggest general medical condition but not explained by any general medical disorder, substance effect, or other psychiatric

disorder; (b) cause clinically meaningful distress or functional impairment; (c) not intentionally produced (vs. factitious disorders, malingering). Psychological factors judged to play major role in symptom onset.








Table 162.1 Somatizing Disorders: Defining Characteristics





































  Conscious intentionality Primary gain Secondary gain Coexisting psychopathology Prognosis
Somatoform
  Disorders
Absent Repress unacceptable
  wishes,
  feelings or
  conflicts
Any pragmatic
  benefits, if present,
  are secondary
Highly variable: May
  include affective,
  anxiety, dissociative,
  psychotic,
  developmental or
  personality disorders
Highly variable: depends
  on chronicity, coexisting
  psychopathology, patient
  resilience, support
  network, treatment
Factitious
  Disorders
Present Assume the
  sick role
Generally no
  significant
  pragmatic benefits;
  if present, are
  secondary
Often includes dependent,
  histrionic, borderline
  or antisocial
  personality features
Often poor,
  especially if
  chronic
Malingering Present Pragmatic
  benefit:
  financial,
  legal, drugs
Circumvent authority Often includes antisocial
  personality disorder
Symptoms are relinquished
  only when the goal is
  either obtained or seen
  as clearly unobtainable
Psychological
  Factors
  Affecting a
  Medical
  Condition
Variable None Any pragmatic
  benefits, if present,
  are secondary
Highly variable Highly variable, depending
  on medical condition,
  chronicity, patient
  resilience, support
  network, treatment

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Jul 27, 2016 | Posted by in NEUROLOGY | Comments Off on Somatoform Disorders

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