Psychosomatic Disorders (Psycho-relating to the mind; Somatic-relating to the
mind)
Basic idea: Psychosomatic phenomena occur when internal stress and emotions, triggered
by obstacles (either external or internal), aren’t properly released. This tension builds up and
can lead to physical symptoms. Initially, the body tries to handle the pain or stress through
immediate reactions, but if these don’t work, the emotional and physical responses can
become disconnected, potentially leading to long-term physical issues.
Psychosomatic disorders have always been described in various forms and often with
interchangeable terms, all of which seeking recognition of the interaction between the mind
and the body of an individual. A psychosomatic disorder happens when mental stress and
distress cause or make a physical condition- and its symptoms-worse.
Psychosomatic vs Somatization Disorders:
Both involve a combination of psychological issues and physical symptoms or conditions. But
their cause-and-effect relationships are different. Somatic symptom disorder (as is in DSM 5)
happens when one has an extreme focus on physical symptoms, like pain, that causes major
distress or problems with daily functioning. A psychosomatic disorder happens when stress
makes physical conditions worse. The DSM 5 does not recognize ‘psychosomatic disorders’ as
a condition.
DSM Version Terminology Key Features Diagnostic Examples of
Criteria Conditions
DSM I (1952) Psychophysiologi Emphasis on Emphasis on Headaches,
cal Autonomic visceral visceral back pain,
and Visceral expression of expression of asthma,
Disorders affect (repressed affect (repressed constipation,
emotions causing emotions causing etc.
physical physical
symptoms) symptoms)
- Chronic - Chronic
physiological physiological
reactions reactions
believed to cause believed to
structural cause structural
changes changes
DSM II (1968) Psychophysiologi Dropped - Conditions Similar to DSM
cal Disorders "autonomic and categorized I with updated
visceral" without terminology
terminology "reaction"
- Introduced new terminology
terms: neurosis,
psychosis,
disorder
- Diagnosis
criteria remained
largely the same
DSM III (1980) Psychological - Replaced - Requires Obesity,
Factors Affecting psychophysiologi evidence of headaches,
Physical cal disorders temporal migraines,
Conditions - Focus on relationship asthma, ulcers,
psychological between rheumatoid
factors psychological arthritis,
influencing factors and tachycardia,
physical physical etc
conditions conditions
- Noted physical - Distinguished
conditions from conversion
influenced by disorders
psychological
factors to be
recorded on Axis
III
DSM IV (1994) Psychological Category - A history of Somatization
Factors Affecting downgraded to a multiple physical disorder,
Physical subsection under complaints conversion
Condition "Other before age 30 disorder, pain
Conditions" - At least: 4 pain disorder,
- Somatization symptoms, 2 hypochondriasi
disorder criteria gastrointestinal s, etc.
introduced symptoms, 1
sexual symptom,
1
pseudoneurologi
cal symptom
DSM-5 (2013) Somatic - Unified category Characterized by Somatic
Symptoms and for somatization significant symptom
Related Disorders disorders and distress or disorder,
psychological disruption in chronic pain
factors affecting functioning disorders,
medical - Diagnosis does adjustment
conditions not require disorder
- Eliminated symptoms to be
overlap across medically
somatoform unexplained
disorders
- No specific
number of
symptoms
required for
diagnosis
