Somatomorphic disorders include: hypochondria, persistent psychogenic pains and dysmorphophobia. They are difficult to diagnose and it happens that a patient wandered from doctor to doctor for many years without receiving psychotherapeutic support. What are the causes and symptoms of somatomorphic disorders? How is their treatment going?

Somatomorphic disordersin the current psychiatric classifications are classified as neurotic disorders. In the terminology used earlier, they were sometimes referred to as organ neuroses. Theoretically, it might seem that psychological problems should not cause bodily ailments, but in practice it turns out that human bodies and minds are closely interconnected. Ultimately, it is noticeable that psychological conflicts can lead, among others, to the somatomorphic disorders described here, but also to the so-called psychosomatic diseases.

There are situations in which the patient experiences some symptoms (e.g. regular pain ailments), and doctors - even after carrying out many different tests - fail to find the cause of their occurrence. The reason does not always have to be diagnostic errors - there is a possibility that the somatic (body) symptoms occurring in a given person are caused by … mental disorders. This is exactly the case with somatomorphic disorders (also called somatoform disorders).

Somatomorphic disorders can be a serious problem, because before the patient receives the appropriate psychotherapeutic support, he or she may (sometimes for many years) visit various specialists repeatedly who will not be able to influence the symptoms they experience.

Somatomorphic disorders: causes

The simplest way to say is that somatomorphic disorders appear as a result of unresolved emotional conflicts. People react differently to emotions that are difficult for them - some patients talk to their relatives or are able to deal with difficult events on their own. In other people, in turn, the emotional conflict "passes" to the body and manifests itself precisely through somatic ailments. It is impossible to distinguish one particular group of causes of somatomorphic disorders. It is related to thiseven with the fact that different people are characterized by a completely different level of emotionality. For example, patients with alexithymia, i.e. with a problem in which there are problems with understanding, expressing and naming emotions, are at an increased risk of developing the described mental disorders. Such people can present their feelings through somatic ailments.

There is a noticeable tendency towards familial occurrence of somatomorphic disorders. When analyzing the basis of such a relationship, mainly two aspects are taken into account. The first is the suspicion that the tendency to somatoform disorders may be genetically determined. The second potential mechanism of the family occurrence of these problems is the fact that a child observing somatising parents in the future may by themselves - completely unconsciously - present similar ways of expressing emotions and coping with them. Difficulties can also contribute to the occurrence of somatomorphic disorders, for most people, events. Examples include, for example, the experience of being harassed by the environment, becoming a victim of rape or mobbing at work. A person dealing with situations that are extremely difficult for him may, in a way, try not to think about them or mention them to anyone. However, an unresolved emotional conflict may remain, which may eventually lead to the appearance of one of the somatomorphic disorders. It should be emphasized that a patient with a somatomorphic disorder does not simulate. Although it is actually mental problems that lead to symptoms, and not some organ defects, patients do experience their symptoms - they are not imaginary ailments and that is why they can significantly adversely affect the daily functioning of people with somatomorphic disorders.

Somatomorphic disorders: types

The classifications of exactly which problems are classified as somatomorphic disorders are not infrequently different. The most often included in this group of mental disorders are: somatization disorders, hypochondriac disorders, dysmorphophobia as well as persistent psychogenic pain and conversion disorders.

  • Somatization disorders

Somatization disorders are probably the most difficult form of somatomorphic disorders to diagnose. Patients may experience pain from many different parts of the body, as well as a number of other problems, such as skin changes, itching or burning. Patients can experience as wellsexual problems (e.g. decreased libido) or neurological ailments (e.g. sensory disturbances). A characteristic feature of somatization disorders is that patients' complaints about their he alth may change over time - for example, abdominal pain may be the main problem, and after some time they may complain of chronic insomnia or joint pain.

  • Somatomorphic disorders: hypochondria

Hypochondriac disorders (hypochondria) are associated with the patient's constant preoccupation with his he alth. He may be convinced that he is suffering from a serious illness and therefore visit the doctor many times, during such visits he may even demand to be referred for further examinations. Hypochondria is characterized by incorrect interpretation of signals from the body - for example, the feeling of a temporarily altered heart rhythm may be perceived as a signal of a life-threatening arrhythmia.

  • Somatomorphic disorders: dysmorphophobia

Dysmorphophobia is partly like hypochondria. In the course of this somatomorphic disorder, patients focus on the appearance of some part of their body. They consider a given element of the body, such as the mouth, nose or teeth, to be extremely improperly built. This belief may be so strong that it can lead to significant complexes, but also to - sometimes even obsessive - desire to correct the appearance of a given structure, e.g. by undergoing plastic surgery. It should be emphasized here that, unfortunately, dysmorphophobia will not be cured by the use of plastic surgeons. First, patients' complaints concern body parts that are built properly. Another aspect is the fact that in the course of dysmorphophobia - even if the appearance of a part of the body is actually modified - patients can still focus on some other, which in their opinion looks incorrect, part of their body.

  • Somatomorphic disorders: persistent psychogenic pains

Persistent psychogenic pains are also sometimes referred to as psychalgia. Pain in their course may concern only one area of ​​the body, and the pain may appear in several different locations. The intensity of symptoms in the case of persistent psychogenic pains is such that it significantly reduces the level of functioning of patients - patients experience problems due to pain, e.g. in professional or family life. Psychalgia can lead to many serious complications, including the risk of addiction to painkillers and even the risk ofsuicide patient.

  • Somatomorphic disorders: conversion disorders

Conversion disorders can be very disturbing because in their course the patient may experience symptoms such as loss of vision, paralysis of a part of the body or loss of sensation. Conversion is still an insufficiently understood psychological problem, it is usually lead to a high degree of emotional conflicts.

Somatomorphic disorders: diagnosis

Identifying somatomorphic disorders is actually making a diagnosis through exclusion. For example, in a patient with abdominal pain, it is necessary to exclude various potential causes of such problems, such as gallbladder stones, cancer of one of the abdominal organs or diverticulitis of the large intestine. Therefore, before a patient is diagnosed with somatomorphic disorders, he or she usually visits many (often different speci alties) doctors.

Characteristic for this group of mental disorders is that the tests performed on the patient do not detect any deviations, and even if any abnormalities are detected, they usually do not in any way explain the ailments that a given person experiences.

Somatomorphic disorders: treatment

Patients with somatomorphic disorders most likely want their symptoms to disappear the most. This is obviously fully understandable, but in the case of this group of mental disorders, treatment is directed not towards their symptoms, but towards the cause that led to them, i.e. some unresolved mental conflict. For this reason, psychotherapy is recommended for people with somatoform disorders. Among its various techniques, cognitive behavioral psychotherapy (CBT) is of particular importance. Its aim is to reduce the level of stress in the patient, but also to teach him how to cope with his somatic symptoms. Thanks to CBT, it is also possible to reduce the patient's preoccupation with the ailments experienced and improve his overall quality of life. In the case of somatomorphic disorders, pharmacotherapy is rarely used. If patients are advised to take some psychotropic drugs, it is rather only when they develop some other psychiatric problems, such as, for example, depressive disorders or anxiety disorders.

Worth knowing

Somatomorphic disorders: controversies and problems

Some doctors emphasize that the diagnosis of disorderssomatomorphs can be abused and lead to unnecessary psychiatric hospitalizations or to the patient overlooking a somatic disease. This is why some scientists believe that even after the diagnosis of somatomorphic disorders, patients should be under the constant care of a doctor and have a checkup from time to time. Another problem related to somatomorphic disorders may result from who takes care of patients with this entity. It probably comes as no surprise that patients usually go first not to a psychiatrist or psychotherapist, but to a family doctor, internist or neurologist. Professionals other than psychiatry in the fields of psychiatry may try to alleviate patients' complaints (eg by advising patients with pain to take painkillers). Such a procedure is certainly justified in some way, but if the patient does suffer from some somatomorphic disorder, regular prescribing medications or constant referral to some tests may aggravate his mental disorders.

Category:

Psychiatry