Somatoform Disorders

Somatoform disorders are group of disorders in which physical symptoms suggesting physical disorders for which there are no demonstrable organic findings or known physiologic mechanisms. There is a strong presumption that the symptoms are linked to psychological factors. The client focuses on the physical signs and symptoms and is unable to control the signs and symptoms. The signs and symptoms increase with psychosocial stressors.

There are three types of somatoform disorders: conversion disorder, hypchondriasis, and somatization disorder.

Conversion Disorder
Conversion disorder is a mental disorder in which an unconscious emotion conflict is expressed as an alteration or loss of physical functioning without any organic causes. The most common conversion symptoms are blindness, deafness, paralysis, and the inability to talk.


Clients with conversion disorder will have physical limitation or disability, feeling of guilt, anxiety, or frustration, low self esteem, feeling of inadequacy, unexpressed anger or conflict, and secondary gain.

Hypochondriasis
Hypochondriasis is a delusion that one is suffering from some disease for which no physical basis is evident. Hypochondriasis can cause impaired social and occupational functioning.

Clients with hypochondriasis will have frequent somatic function, complaints of fatigue and insomnia, preoccupation with physical function, anxiety, difficulty expressing feelings, extensive use of remedies or nonprescription medications, repeatedly visiting doctors, and secondary gain.

Somatization Disorder
Somatization disorder is a mental disorder characterized by complicated medical history and multiple physical complains involving multiple body systems without any organic basis. Somatization disorder can result from anxiety, fear, depression, worry or repressed anger. The client may use somatization for secondary gains such as increased attention or decreased responsibilities.

Clients with somatization disorder will have physical complaints of pain, signs of anxiety, fear and low self esteem, psychosocial symptoms, and secondary gains.

Specific Interventions for somatiform disorders:

• Assess nursing history and physical problems
• Do not reinforce the sick role and discourage verbalization about physical symptoms.
• Allow specific time period to discuss physical complaints.
• Assist client to identify alternative ways of meeting needs.
• Convey understanding that the physical symptoms are real to the client and assure that physical illness has been ruled out.
• Explore the source of anxiety and encourage verbalization of anxiety.
• Use relaxation techniques as the anxiety increases.
• Encourage diversional activities to decrease the focus on self.
• Report and assess any new physical complaint.
• Positive feedback for accomplishments.
• Establish a written contract with the client.
• Administer anti-anxiety medication as prescribed.