Somatoform Disorders

• psychosomatic began to be used to convey the connection between the mind (psyche) and the body (soma) in states of health and illness.
• hysteria refers to multiple physicalcomplaints with no organic basis; the complaintsare usually described dramatically
• Somatization is defined as the transference of mental experiences and states into bodily symptoms.
• Somatoform disorders can be characterized as the presence of physical symptoms that suggest a medical condition without a demonstrable organic basis to account fully for them
• Pain symptoms: complaints of headache; pain in the abdomen, head, joints, back, chest, rectum; pain during urination, menstruation, or sexual intercourse
• Gastrointestinal symptoms: nausea, vomiting, diarrhea, constipation, bloating, indigestion, loss of appetite, excessive hunger, food intolerance, difficulty swallowing
• Neurological symptoms: dizziness, fainting spells, seizures, tremors, paralysis, weakness, numbness, tingling, paresthesias, blind spots, double vision, hearing problems, ringing in ears, deafness, speech difficulties, stuttering, slurred speech, memory loss, confusion, disorientation, hallucinations, delusions, depersonalization, derealization, amnesia, dissociative identity disorder
• Sexual dysfunction: decreased libido, impotence, premature ejaculation, vaginismus, painful intercourse, frigidity, anorgasmia, menorrhagia, amenorrhea, irregular periods, infertility, premenstrual syndrome
• Conversion disorder, sometimes called conversion reaction, involves unexplained, usually sudden deficits in sensory or motor function (e.g., blindness, paralysis).
• la belle indifference, a seeming lack of concern or distress, is a key feature.
• Pain disorder has the primary physical symptom of pain, which generally is unrelieved by analgesics and greatly affected by psychological factors in terms of onset, severity, exacerbation, and maintenance
• Hypochondriasis is the preoccupation with the fear that one has a serious disease (disease conviction) or will get a serious disease(disease phobia). It is thought that clients with this disorder misinterpret bodily
• Body dysmorphic disorder is preoccupation with an imagined or exaggerated defect in physical appearance such as thinking one’s nose is too large or teeth are crooked and unattractive.
• All the somatoform disorders are either chronic or recurrent
• Pain disorder and hypochondriasis can occur at any age
• Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms
• Factitious disorder occurs when a person intentionally produces or feigns physical or psychological symptoms solely to gain attention. The common term for ______ is Munchausen’s syndrome
• Munchausen’s by proxy, occurs when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a “hero” for saving the victim.
• Psychosocial theorists believe that people with somatoform disorders keep stress, anxiety, or frustration inside rather than expressing them outwardly. This is called internalization.
• Primary gains are the direct external benefits that being sick provides such as relief of anxiety, conflict, or distress
• Secondary gains are the internal or personal benefits received from others because one is sick such as attention from family members and comfort measures
• men in India often have dhat, which is a hypochondriacal concern about loss of semen
• Koro occurs in Southeast Asia and may be related to body dysmorphic disorder
• Hwa-byung is a Korean folk syndrome attributed to the suppression of anger and includes insomnia, fatigue, panic, indigestion, and generalized aches and pains
• Falling-out episodes, found in the southern United States and the Caribbean islands, are characterized by a sudden collapse during which the person cannot see or move
• Sangue dormido (“sleeping blood”) occurs among Portuguese Cape Verde Islanders who report pain, numbness, tremors, paralysis, seizures, blindness, heart attack, and miscarriages.
• Shenjing shuariuo occurs in China and includes physical and mental fatigue, dizziness, headache, pain, sleep disturbance, memory loss, gastrointestinal problems, and sexual dysfunction
• Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil), are used most commonly
• fluoxetine (Prozac), monitor for rash, hives, insomnia, headache, anxiety, drowsiness, nausea, and loss of appetite; avoid alcohol
• paroxetine (paxil) Monitor for nausea, loss of appetite, dizziness, dry mouth, somnolence or insomnia, sweating, sexual dysfunction; avoid alcohol
• sertraline (Zoloft) Monitor for nausea, loss of appetite, diarrhea, headache, insomnia, sexual dysfunction; avoid alcohol