• Somatisation Disorder

    by  • 28/12/2013 • Psychiatry

    Definition

    Characterised by the following:

    • Over 2 years of multiple, variable physical symptoms of no underlying cause (they are cause by psychological problems).
    • Refusal to accept doctor’s reassurance.
    • Impairment of social function
    • Symptoms not intentionally produced

     

    Patients often see many doctors of different specialties and undergo investigations with negative outcomes.

    There is often associated social/family disruption.

    Causes

    There is some evidence that somatization disorder is more common in people who experienced parental physical illness as children.

     

    Diagnosis

    Somatisation is a diagnosis of exclusion, and the development of a physical illness needs to be excluded.

    Patient will often present with:

    • Multiple symptoms, often occurring in different organ systems.
    • Symptoms that are vague or that exceed objective findings.
    • Chronic course.
    • Presence of a psychiatric disorder.
    • History of extensive diagnostic testing.
    • Rejection of previous physicians.

     

    Management

    The goal of treatment is to help the person learn to control the symptoms:

    • Antidepressants- there is often an underlying mood disorder.
    • Psychotherapy- cognitive behavioural therapy has been shown to reduce intensity and frequency of somatic complaints.

     

    Unfortunately, persons with this disorder rarely admit that it can be caused, at least in part, by mental health problems, and may refuse psychiatric treatment.

     

    Prognosis

    • Complications may result from invasive testing and multiple evaluations.
    • A dependency on pain relievers or sedatives may develop.
    • A poor relationship with the healthcare provider seems to worsen the condition.
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