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Somatoform disorders are a group of psychological conditions where the physical symptoms are present in the patient and it cannot be attributed to any medical condition or substance abuse. The term somatoform disorder has been replaced by a newer term in DSM 5 namely the somatic symptom disorder. The cognitive behavioral therapy constitutes the main mode of treatment of this disorder. The antidepressant has shown beneficial effect in the pain of the somatoform disorder. This disorder would be described in detail in this article.

Psychological Factors Affecting Other Medical Conditions

The DSM-5 has always faced criticism over the term “psychological factors affecting other medical conditions” because the clinical application was always unclear. The simplest way to define this term might be the presence of psychological or behavioral factors that adversely affect an organic medical condition in a patient with confirmed medical illness other than a mental disorder. These psychological factors should show a positive temporal relationship with disease’s exacerbations or delayed recovery.

Somatic Symptom Disorder — Pathophysiology and Treatment Options

Somatic Symptom Disorder is a condition that is characterized by the presence of one or more somatic symptoms that are associated with excessive thoughts and feelings about them which lead to excessive behaviors. This should be associated with significant distress in the everyday life of the patient. Patients who are diagnosed with somatic symptom disorder should be given full medical care whenever they present to the emergency department, and proper exclusion of life-threatening conditions, such as a myocardial infarction, is needed. Patients with a good insight into their condition respond well to cognitive-behavioral therapy.

Somatic Pain Disorder — Diagnostic Criteria and Brain Imaging

Somatic pain disorder is very common in the general population, especially in females. The previous history of sexual, physical or emotional abuse might increase the risk of chronic pain syndrome and somatic pain disorders. The diagnosis is based on the DSM-IV criteria. Brain imaging studies have identified novel therapeutic targets which are very promising in the management of chronic pain. The current treatment options include antidepressants, group psychotherapy, and the proper explanation of the nature of the symptoms and the most likely cause.

Malingering — Causes and Detection

Malingering is not a medical diagnosis. It is a condition that is characterized by providing intentional false information about non-existent symptoms or by exaggerating real symptoms to get some gain. This gain is usually in the form of financial compensation, avoiding work, or avoiding criminal prosecution. Symptom validity tests are used to detect cases of malingering. Once the possibility of malingering is confirmed, the best approach should be the confrontation of the subject.

Dissociative Fugue — Causes and Treatment Options

A dissociative fugue is a specific form of dissociative amnesia that is characterized by the memory loss of one’s identity and past life, in addition to the unexpected and purposeful travel away from home without planning or warning. The patient might also create a new identity to compensate for the severe memory loss without a conscious acknowledgement and a reason of the flight. Fugue has been suggested to be caused by severe traumatic life events or stress. Patients with fugue might respond to cognitive therapy or hypnosis. Barbiturates might be used for a medicated-interview to reveal more information about a suppressed traumatic trigger.

Dissociative Identity Disorder (DID) — Causes and Diagnostic Criteria

Dissociative identity disorder is a rare condition that is characterized by the presence of two or more distinct personality identities in the patient. The condition resembles possession. Dissociation is an essential part in the diagnosis without which, the diagnosis cannot be made. Treatment of dissociative identity disorder involves the identification of the most likely childhood trauma that caused the split, and fusion therapy to fuse as many personalities as we can into one coherent personality.

Overview of Dissociative Disorders: Dissociative Identity Disorder, Dissociative Amnesia and Dissociative Fugue

Dissociative disorders are a group of psychiatric conditions that are characterized by dissociation. Dissociation is defined as forgetting or abandoning one’s own identity and the loss of certain autobiographical memories in the process. Based on this definition, the most important dissociative disorders to study are dissociative identity disorder, dissociative amnesia, and fugue. Multiple personality disorder with dissociation or amnesia is now known as dissociative disorder, non-specified.

Depersonalization Disorder (DPD) and Depersonalization-Derealization Syndrome — Causes and Diagnostic Criteria

Depersonalization or Derealization symptoms are common in the general population. The recurrent or almost persistent episodes of depersonalization or derealization are the cornerstone for the diagnosis of this disorder. It is reported in about 2 % of the population. These recurrent episodes are characterized by experiencing unreality about one’s own self, i.e. depersonalization, or one’s surroundings, i.e. derealization. Crisis intervention therapy during the acute episodes, combined with psychodynamic therapy during asymptomatic period is the main line of treatment for depersonalization/derealization disorder.

Dissociative Amnesia (Psychogenic Amnesia) — Causes and Treatment

Dissociative dementia is a type of dissociative disorder characterized by temporary memory gap achieved to compensate any stressful or traumatic event of life. It involves an incapability to recall personal information, usually of a trauma or stressful event consciously. The forgotten information remains in conscious part of mind which can influence the behavior of the patient. Additionally, dissociative amnesia is more common in patients with other comorbid psychiatric illness such as depression and conversion disorder. Dissociative amnesia might be generalized or localized or continuous or systematized. The most common type is the localized loss of certain life events that are usually traumatic and unpleasant.

Body Dysmorphic Disorder (BDD) — Signs and Treatment

Body dysmorphic disorder is a common psychiatric condition that is characterized by the preoccupation with false ideas about one’s own physical appearance. This preoccupation leads to repetitive compulsive behavior that aims to fix the perceived physical defects. Patients with body dysmorphic disorder might have good insight, poor insight or completely absent insight. When patients have poor insight or completely absent insight into their condition, cognitive-behavioral therapy might fail. Patients with good insight who know that their beliefs about their body appearance are probably wrong usually respond well to intensive cognitive-behavioral therapy. Serotonin-reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and some antiepileptic medications have been used for the pharmacotherapy management of body dysmorphic disorder.

Dissociative Disorders: Overview 03:43 min

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Dissociative Disorders: Overview 1 article
Dissociative Amnesia 08:28 min

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Dissociative Fugue 07:27 min

Dissociative Fugue 5 quiz questions

Dissociative Fugue 1 article
Dissociative Identity Disorder 06:12 min

Dissociative Identity Disorder 6 quiz questions

Dissociative Identity Disorder 1 article
Depersonalization and Derealization Disorder 05:28 min

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Depersonalization and Derealization Disorder 1 article
Somatization 05:29 min

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Somatization Disorder 06:39 min

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Somatization Disorder Assessment 03:14 min

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Past Medical Illness 04:21 min

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Somatic Symptom and Other Disorders 06:53 min

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Psychological Factors Affecting Other Medical Conditions 08:42 min

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Body Dysmorphic Disorder and Pain Disorder 04:26 min

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Malingering 03:15 min

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Dissociative Disorders and Somatoform Disorders

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Your Educators of course Dissociative Disorders and Somatoform Disorders

Helen Farrell, MD

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