Somatic symptom and related disorders are mental health conditions characterized by an excessive, intense focus on physical (somatic) symptoms that causes significant distress and/or interferes with daily functioning. These symptoms may develop with or without the person being conscious of their origins.
Most mental health conditions are characterized by mental health symptoms. That is, people have unusual or disturbing thoughts, moods, and/or behaviors. However, in somatic symptom disorders, psychological factors are expressed as physical symptoms—a process called somatization—and the person's main concern is with physical symptoms, such as pain, weakness, fatigue, nausea, or other bodily sensations. The person may or may not have a general medical condition that causes or contributes to the symptoms. However, when a general medical condition is present, a person with somatic symptom or a related disorder responds to it disproportionately.
It is not unusual to have an emotional reaction to physical symptoms. However, people with a somatic symptom disorder have exceptionally intense thoughts, feelings, and behaviors in response to their symptoms. A disordered reaction to feeling ill is distinguished from a normal reaction by its intensity, which causes significant distress to the person (and sometimes to others) and/or makes it difficult for the person to function in daily life.
In the standard psychiatric diagnostic manual, the different responses people have define the specific disorder they have, as in the following:
In somatic symptom disorder, people's symptoms concern and preoccupy them, worry them constantly, and/or drive them to see doctors very frequently.
In illness anxiety disorder (previously known as hypochondria or hypochondriasis), people are excessively preoccupied with and worried about the possibility of having or getting a serious illness.
In functional neurological symptom disorder (formerly known as conversion disorder), physical symptoms that resemble those of a nervous system disorder develop.
Sometimes attitudes or behaviors can have a negative effect on a general medical illness that a person has—a disorder called psychological factors affecting other medical conditions.
In factitious disorders (either imposed on self or imposed on another), people pretend that they or someone else has symptoms even when there is no obvious tangible external benefit to be gained (such as getting time off from work). The motivation for such behaviors is often unclear.
Malingering is not a somatic symptom disorder, but it may be mistaken for one. It refers instead to a behavioral pattern characterized by intentionally faking physical or psychological symptoms when motivated by an external incentive or reward (for example, pretending to be sick to get time off). The presence of such an incentive distinguishes malingering from factitious disorders, which are typically motivated by internal forces, such as the need for attention or sympathy.
Because people with these disorders think they have physical symptoms, they tend to go to a medical doctor rather than to a mental health care professional.
Somatic symptom or related disorders may also occur in children.
Treatment varies according to which disorder a person has but usually involves psychotherapy.
Mind and Body
How the mind and body interact to influence health has long been discussed. Although people speak casually about mind and body as though they were distinct, they are actually so interrelated that it is hard to separate their effects, as in the following cases:
When physical symptoms result from stress or psychological factors, doctors may have difficulty identifying the cause. Various diagnostic tests may be required to clarify the situation. |
