Chapter 21-A
Somatic Symptom Illnesses
Psychosomatic
• mind (psyche) + body (soma)
Psychosomatic was a term rst used to convey the
connection between the mind (psyche) and the
body (soma) in states of health and illness.
Essentially the mind can cause the body to create
physical symptoms or to worsen physical illnesses.
• Real symptoms can begin, continue, or be
worsened as a result of emotional factors.
• HYSTERIA refers to multiple physical complaints
with no organic basis; the complaints are usually
described dramatically.*
• Sigmund Freud obse ed that people with
hysteria improved with hypnosis
* Somatization is the transference of mental
experiences and states into bodily symptoms.
Somatoform disorders are the presence of physical
symptoms that suggest a medical condition
without a demonstrable organic
basis to account fully for them.
The three central features of somatoform disorders:
1. Physical complaints suggest major medical illness but
have no demonstrable organic basis
2. Psychological factors and con icts seem impo ant in
initiating, exacerbating, and maintaining the symptoms
3. Symptoms or magni ed health concerns are not under the
client’s conscious control *
Speci c somatoform disorders:
1. Somatic symptom disorder: multiple physical symptoms;
combination of pain, GI, sexual, and pseudoneurologic
symptoms
2. Conversion disorder: unexplained de cits in senso or
motor function associated with psychological factors;
attitude of la belle indi erence (lack of concern or distress)
Speci c somatoform disorders:
3. Pain disorder: pain unrelieved by analgesics;
psychological factors in uence onset, severity,
exacerbation, and maintenance
4. Hypochondriasis, or illness anxiety disorder:
preoccupation with the fear that one has a serious
disease (disease conviction) or will get a serious
disease (disease phobia)
Onset and Clinical Course
• Somatization disorder, conversion disorder, and
pain disorder are more common in women.
• Hypochondriasis and body dysmorphic disorders
occur equally in men and women.
Onset and Clinical Course
• All somatoform disorders are either chronic or recurrent,
lasting for decades.
• Onset of somatization and body dysmorphic disorder is 25
years; conversion disorder, 10 to 35 years; pain disorder
and hypochondriasis occur at any age.
• Clients with somatization disorder and
conversion disorder most likely seek help from
mental health professionals after they have
exhausted e o s at nding a diagnosed medical
condition.
• Clients with hypochondriasis, pain disorder, and
body dysmorphic disorder are unlikely to receive
treatment in mental health settings unless they
have a comorbid condition
• Clients with somatoform disorders tend to go from one
physician or clinic to another, or they may see multiple
providers at once in an e o to obtain relief of symptoms.
•END OF CHAP 20 SET A
