Sexual symptoms Many people who have SSD will also have an anxiety disorder.
Overview Overview The somatoform disorders are a group of psychological disorders in which a patient experiences physical symptoms that are inconsistent with or cannot be fully explained by any underlying general medical or neurologic condition. The somatoform disorders represent the severe end of a continuum of somatic symptoms.
Somatization in children consists of the persistent experience and complaints of somatic distress that cannot be fully explained by a medical diagnosis. They can be represented by a wide spectrum of severity, ranging from mild self-limited symptoms, such as stomachache and headache, to chronic disabling symptoms, such as seizures and paralysis.
These psychological disorders are often difficult to approach and complex to understand. It is important to note that these symptoms are not intentionally produced or under voluntary control. In somatoform disorders, somatic symptoms become the focus of children and their families.
They generally interfere with school, home life, and peer relationships. These youngsters are more likely to be considered sickly or health impaired by parents and caretakers, to be absent from school, and to perform poorly in academics.
Somatization is often associated temporarily with psychosocial stress and can persist even after the acute stressor has resolved, resulting in the belief by the child and his or her family that the correct medical diagnosis has not yet been found. Thus, patients and families may continue to seek repeated medical treatment after being informed that no acute physical illness has been found and that the symptoms cannot be fully explained by a general medical condition.
When somatization occurs in the context of a physical illness, it is identified by symptoms that go beyond the expected pathophysiology of the physical illness. Recurrent complaints often present as diagnostic and treatment dilemmas to the primary care practitioner PCP who is trying to make sense of these symptoms.
While the more disabling somatic complaints are more likely to be referred to a mental health professional, these youngsters presenting with these disabling physical symptoms bridge both medical and psychological domains and present a puzzling quandary for professionals from either field if working with them alone.
Patients with these disorders typically present to general medical settings rather than to mental health settings. These disorders all involve clinically significant distress or impairment in daily functioning.
The diagnostic criteria for these somatoform disorders are established for adults, but not many published case studies and research have focused on pediatric populations. It must be noted that DSM-IV is currently under revision with a proposal to rename the classification to somatic symptom disorders and complex somatic symptom disorders.
Clinical vignettes are included to illustrate each disorder, and the reader is referred to comprehensive Medscape Reference articles for further reading.
The conclusion of the article includes suggested methods to approach assessment and treatment. This diagnosis was historically referred to as hysteria or Briquet syndrome. All the following historical criteria are required for a diagnosis [ 7 ]: Four different pain sites eg, head, abdomen, back, joints, extremities, chest, rectum or painful functions eg, menstruation, sexual intercourse, urination Two gastrointestinal symptoms other than pain eg, nausea, bloating, vomiting, or intolerance of several different foods One sexual or reproductive symptom other than pain eg, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding One pseudoneurological symptom eg, impaired balance, paralysis, aphonia, urinary retention After appropriate investigation, a known general medical condition or direct effects of a substance cannot explain the multiple symptoms.
When a related medical condition is present, the physical complaints are in excess of what would be expected.
The criteria for somatization disorder were designed for adults, and attempts have been made to apply criteria to pediatric populations since adolescents can present to primary care facilities with many of these symptoms.
Nevertheless, this diagnosis is rarely made in the adolescent population, mainly because of the time requirement of several years that is needed to meet the symptom criteria. Somatization disorder case example Susan was a year-old girl with a 2-year history of body aches, fatigue, fevers reported but not documentedheadaches, diarrhea, nausea, joint pain, dysuria, and irregular menses.
Her mother stated that she had chronic fatigue syndrome CFS. During multiple medical clinic visits, Susan repeatedly had normal findings on physical and extensive laboratory examinations.
While being evaluated by neurology department personnel for her headaches, Susan became completely mute. Following a negative medical workup, she was admitted to a psychiatry inpatient unit, where she began talking upon arrival. Gambling and domestic violence in the home were also identified.
Susan was placed in foster care, resulting in some decrease in her somatic complaints. Susan subsequently recanted her previous allegations of physical and sexual abuse to child protective services. Despite family court involvement, she was allowed to return home and was lost to follow-up.
Susan met criteria with 2 years of complaints of recurrent aches and pains, pain with urination, nausea, and constipation.
CFS was in the differential diagnosis. It was felt that her somatic complaints were a reflection of her distress from secretly living with incest, physical abuse, and domestic violence.Causes. The exact cause of somatic symptom disorder isn't clear, but any of these factors may play a role: Genetic and biological factors, such as an increased sensitivity to pain Family influence, which may be genetic or environmental, or both Personality trait of negativity, which can impact how you identify and perceive illness and bodily .
Mental disorders or mental illness in behavior generally associated with distress or disability. The doctors of Encino psychiatrists in the San Fernando Valley can help. Somatization disorder (also Briquet's syndrome) is a mental disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic symptoms, although it is no longer considered a clinical diagnosis.
It was recognized in the DSM-IV-TR classification system, but in the latest version DSM-5, it was combined with undifferentiated somatoform disorder to become.
This lucidly written guide presents an innovative approach for treating somatization disorder and related problems, such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome.
Mar 04, · Somatization disorder. The essential feature of a somatization disorder is a pattern of many physical complaints in persons younger than 30 years that occurs over several years and results in unnecessary medical treatment and/or causes significant impairment in functioning.
Somatization disorder Somatization disorder is very similar to undifferentiated somatoform disorder and the two can be easily confused. The symptoms are the same, but the diagnostic criteria are much more specific for somatization disorder.