Somatic Symptom Disorders: Symptoms and Treatment

· October 10, 2018

Somatic symptom disorders bring to light the difficulty of separating the effects that the body and mind have on a person’s health. The strong interconnection between these two dimensions hinders the diagnosis and treatment of these types of disorders.

Before continuing, it’s important to differentiate them from psychosomatic disorders. Although both types have a psychological trigger with physical symptoms, psychosomatic disorders include damage to the physiological system, while somatic symptom disorders don’t have a demonstrated physical organic pathology. Therefore, they’re somatic symptom disorders when there are physical symptoms without the presence of organic or physiological ailments. Additionally, this symptomatology includes certain psychological conflicts.

People with this type of disorders make their symptoms the center of attention in their lives. Their discomfort may even absorb them in their everyday activities. However, in many cases, their concern is disproportionate related to their actual symptoms.

Excessive symptom magnification

As stated before, patients who suffer somatic symptom disorders show physical symptoms, but their origin is psychological. These come along with high levels of worry, anxiety, and difficulties in their daily activities. The following key points summarize their clinical picture:

  • Excessive worry about their symptoms and/or intense emotional disturbance.
  • Recurring, constant, and obsessive thoughts about the possible severity of the symptoms.
  • Extreme anxiety about their health and the catastrophic consequences of their symptoms.
  • A disproportionate amount of time and money spent on health issues.
Woman suffering somatic symptom disorders.


Dependence

People can start to develop a dependency on others caused by the chronicity of the physical symptoms and the belief that their sorrow will lead to catastrophic consequences. These patients generate a need to be taken care of constantly. And so, on one side, they elude their responsibilities and, on the other, they demand excessive attention, help, and support from the people around them.

In addition, they tend to get angry when they feel that they’re not getting the time or attention they feel they deserve or when their necessities are undervalued. They may experience strong emotional volatileness that may result in suicide attempts in severe cases. Evidently, somatic symptom disorders can be very serious if not detected early on.

Difficult detection

What is the diagnosis for a series of ailments that show no signs of a physical disorder? The answer to this question lies in the psychological component of these disorders. And so, to diagnose them, “there should be no evidence of a somatic base that explains the symptoms” according to the DSM-IV.

Nevertheless, doctors shouldn’t diagnose this as a mental disorder when they don’t find a physical cause of the symptoms. Before that, they should make sure to run the necessary tests.

Some people may also react in an exaggerated manner because they have a lower pain threshold than most people. But that doesn’t mean that they have a mental illness. To diagnose this type of disorder, doctors must first rule out the possibility of other physical or organic disorders.

Man with a stomachache.

Types of somatic symptom disorders

In order to categorize somatic symptom disorders, we must pay attention to the response the patient has to the symptoms they experience. In other words, worry, anxiety, and the degree of interference that their ailments have in their everyday life. Therefore, depending on these reactions, we can then distinguish the following specific disorders (DSM-IV and ICD-10):

  • Somatization: usually detected after many years. The symptoms can manifest in any part of the body, but the most common are gastrointestinal (pain, meteorism, vomit, nausea, etc.) and dermic (burns, tingling sensation, redness) problems. In some cases, we can also see signs of depression and anxiety.
  • Undifferentiated: characterized by multiple physical ailments that are variable and persistent, but have no explanation. This means that their symptoms aren’t enough to establish a diagnosis of somatization.
  • Hypochondriasis: probably one of the better-known types of somatic symptom disorders. Its main symptoms are the worry and fear of developing or having one or many serious progressive illnesses. The patient often categorizes normal or frequent sensations as exceptional phenomena.
  • Conversion: its symptoms manifest in organs connected with the autonomic nervous system (cardiovascular, gastrointestinal, or breathing systems). Also, in a combination of objective signs of hyperactivity (throbs, sweating, flushing, and shaking) and other subjective and unspecific signs.
  • Pain: characterized by intense pain that manifests mainly in conflictive or problematic situations.
  • Others: sensibility alterations to somatic disorders and related to problems or stressful events. For example, episodes of hysteria or teeth grinding.

Cognitive behavioral therapy

Although there are studies about pharmaceutical treatment for pain, there isn’t enough scientific proof to make viable therapeutic recommendations. However, patients should seek out psychotherapy and specifically cognitive behavioral therapy. This could help reduce their anguish and anxiety over their symptoms.

Another effective treatment could be an integral focus on cognitive behavioral therapy and interpersonal therapy. This combination contemplates the two main characteristics of the patients with somatic tendencies: the exaggerated perception and evaluation of their health and the inadequate way they communicate their ailments to others.

This type of condition has a high incidence in our society. However, we mustn’t obsess or worry. In some cases, the physical symptoms are a product of a mental condition. And so, as we established at the beginning of the article, this is a result of the relationship between the mind and the body. The clear question that comes out of this is: where is the line that divides physical and mental symptoms?