Somatoform Disorder: 5 Questions that Have You Puzzled.

1. What is Somatoform Disorder?
The Somatoform Disorder is a form of mental illness. Also known as the Somatic symptom disorder (SSD), it causes one or more bodily symptoms including pain.
The symptoms may or may not be traceable to a physical cause including general medical conditions, other mental illnesses, or substance abuse. But regardless, they cause excessive and disproportionate levels of distress. The symptoms can involve one or more different organs and body systems, such as:

• Pain
• Neurologic problems
• Gastrointestinal complaints
• Sexual symptoms

Many people who have SSD will also have an anxiety disorder.

Must read about - Anxiety Disorder Risk Factors, Diagnosis and Treatment

2. How does a patient suffering from Somatoform Disorder behave?

• It is important to remember that people with SSD are not faking their symptoms. The distress they experience from pain and other problems they experience are real, regardless of whether or not a physical explanation can be found.
• The distress from symptoms significantly affects their daily functioning.
• The diagnosis of SSD can create a lot of stress and frustration for patients.
• They may feel unsatisfied if there's no better physical explanation for their symptoms or if they are told their level of distress about a physical illness is excessive.
• The stress often leads patients to become more worried about their health, and this creates a vicious cycle that can persist for years.

3. What are some conditions related to the Somatic Symptom Disorder
Psychiatry describes many conditions related to SSD. These include:

• Illness Anxiety Disorder (formerly called Hypochondriasis). People with this type are preoccupied with a concern they have a serious disease. They may believe that minor complaints are signs of very serious medical problems. For example, they may believe that a common headache is a sign of a brain tumour.
• Conversion disorder (also called Functional Neurological Symptom Disorder). This condition is diagnosed when people have neurological symptoms that can't be traced back to a medical cause.

For example, patients may have symptoms such as:

• Weakness or paralysis
• Abnormal movements (such as tremor or unsteady gait)
• Blindness
• Hearing loss
• Loss of sensation or numbness
• Headaches
• Vomiting
• Nausea, bloating
• Abdominal pain
• Diarrhoea or constipation
• Pain in arms or legs
• Fatigue, Fainting
• Pain during urination
• Difficulty swallowing
• Amnesia
• Seizures
  
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If you do see any of these symptoms in a patient, do make sure you have a calming and relaxed atmosphere in the house. These symptoms get aggravated by stress which usually makes the disorder worse.

4. What are some key points to remember regarding SSD?

• Although symptoms are primarily physical, the patient might suffer from anxiety and disorder too.
• Typically, patients are dramatic & emotional when recounting their symptoms, often referring to them as 'unbearable.'
• Physicians are usually compelled to conduct many physical examinations & tests to make sure that the patient has no physical disorder.
• Patients are usually unaware that their basic problem is psychological & hence they urge the physicians for medical tests & treatments.
• Often dissatisfied with their medical care, they may go from one physician to another with hosts of investigation reports & case summaries ( Fat file syndrome).
• The intensity & persistence of symptoms reflects the patient's strong desire to be cared for in every aspect of life as they believe that they are 'sicker than the sick .
• Patients become extremely dependent in their personal relationships. They increasingly demand help & emotional support & may become enraged when they feel their needs are not being met.
• Symptoms may help the patient avoid the responsibilities of adulthood, but they may also prevent pleasure & act as punishment, suggesting underlying feelings of unworthiness & guilt.

5. How can the Somatic Symptom Disorders be treated?
A realistic focus could be on the reduction of symptoms than a complete cure. The guiding principle is one of care rather than cure. It is important to acknowledge that the distress of the patient is real even though no specific cause can be found for the problem.

• Antidepressants might be of help in some patients. These patients pay undue attention to innocuous side effects.
• Relaxation techniques can help by reducing the arousal level & the associated anxious preoccupations.

Usually, the best treatment is a calm, supportive relationship with a physician who offers symptomatic relief & protects the patient from unnecessary diagnostic or therapeutic procedures.

Article by Dr. Naveen Nadipelli, MBBS, DPM (Psychiatry),
Consultant Psychiatrist, CallHealth

Have a Question? Consult Dr. Naveen Nadipelli online.