1. Sheila Lechado, RN
Somatoform Disorders

2. OVERVIEW

3. Somatoform disorders
• Characterized by complaints of physical
symptoms that cannot be explained by known
physical mechanisms
• These disorders have in common the belief
that physical symptoms are real despite
evidence to the contrary.
• The affected individual experiences changes
or loss in physical function.

4. • The physical symptoms are not under the
individual's voluntary control
• Significant impairment occurs in social or
occupational functioning

5. CLASSIFICATION

6. • Somatization disorder
• Undifferentiated somatoform disorder
• Conversion disorder
• Pain disorder
• Hypochondriasis
• Body dysmorphic disorder
• Somatoform disorder not otherwise specified

7. DIAGNOSTIC EVALUATION

8. • Individuals with somatoform disorders will
present in the medical rather than the
psychiatric setting because of their belief that
the problems are medical
• The individual should receive a thorough
medical evaluation
– if possible, avoiding repeating tests that have
already had negative results

9. • The diagnosis of somatoform disorder will be
made after a thorough medical evaluation in
which no organic basis for the symptoms is
validated

10. MANAGEMENT

11. • Level and setting of care to be provided is
determined
– In general, the individual will be treated on an
outpatient basis, unless underlying mood disorder
is present leading to risk for self-harm
• Referral to psychiatric treatment is generally
rejected by the individual with a somatoform
disorder

12. • GOAL:
– To maintain a long-term relationship with a
specific health care provider to prevent patient
from seeking multiple providers with multiple
recommendations for testing, treatments, and
drugs

13. Psychotherapy
• Psychodynamic
– assist the individual to express conflicts and
emotions verbally rather than displacing them
onto physical symptoms.
• Behavioral
– establish a program whereby adaptive behavior is
reinforced and illness behaviors do not receive
secondary gains.

14. Psychotherapy
• Cognitive
– restructure belief system that perpetuates illness-
related behaviors.
• Family therapy
– assist family members to define appropriate
boundaries and support patient in increasing self-
responsibility.

15. • Somatic therapies
– Somatoform disorders are usually not
treated with psychopharmacologic drugs
because these patients are susceptible to
dependency on drugs used.

16. • Mood disorders, especially depression, are a
common comorbid problem in individuals
with somatoform disorders
• Antidepressant drugs may be used to treat the
mood disorder.