What is the common feature of somatoform disorders?
the presence of physical symptoms that suggest a general medical condition and are not fully explained by a general medical condition, by the direct effects of a substance, or by another mental disorder
What is the essential feature of somatization disorder?
a pattern of recurring, multiple, clinically significant somatic complaints
What makes a somatic complaint clinically significant?
if it results in medical treatments
if it causes significant impairment in social, occupational, or other important areas of functioning
What are the requirements for somatic complaints to fit into criterion A of somatization disorder?
beginning before age 30
occur over a period of several years
result in treatemnt being sought or significant impairment in social, occupational, or other important areas of functioning
What is the B criteria for somatization disorder?
B. Each of the following criteria must have been met, with individual symptoms occurring at any time during the course of the disturbance:
- four pain symptoms
- two gastrointestinal symptoms
- one sexual symptom
- one pseudoneruological symptom
What qualifies the pain symptoms in somatization disorder?
a history of pain related to at least four different sites or functions (head, abdomen, back, joints, extremities, chest, rectum, during menstruation, during sexual intercourse, or during urination)
What qualifies the gastrointestinal symptoms for somatization disorder?
a history of at least two gastrointestinal symptoms other than pain (nausea, bloating, vomiting other than during pregnancy, diarrhea, or intolerance of several foods)
What qualifies the sexual symptom of somatization disorder?
a history of at least one secual or reproductive symptom other than pain (sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding, vomiting throughout pregnancy)
What qualifies as a pseudoneurological symptom for somatization disorder?
a symptom or deficit suggesting a neurological condition not limited to pain (conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, seizures; dissociative symptoms such as amnesia, or loss of consciousness other than fainting)
What is the C criterion for somatization disorder?
Either 1 or 2:
- after appropriate investigation, each of the symptoms in criterion B cannot be fully explained by a known general medical condition or the direct effect of a substance
- when there is a related general medical condition, the physical complaints or resulting social/occupational impairment are in excess of what would be expected from the history, physical examination, or laboratory findings
What is criterion D for somatization disorder?
D. The symptoms are not intentionally produced or feigned (as in factitious disorder or malingering).
What are characteristic attributes of people with somatization disorder?
describe complaints ini colorful, exaggerated terms, lacking specific factual information
often seek treatment from several physicians concurrently
prominent anxiety symptoms and depressed mood common
What differentiates somatization disorder from a general medical condition?
involvement of multiple organ systems
early onset and chronic course without development of physical signs or structural abnormalities
absence of laboratory abnormalities that are characteristic of the suggested general medical condition
How can somatization disorder be differentiated from schizophrenia?
schizophrenia may include multiple somatic delusions, but somatization disorder features somatic complaints that are nondelusional
How can somatization disorder be differentiated from panic disorder?
in panic disorder, somatic symptoms are generally contained within a panic attack
How can somatization disorder be differentiated from generalized anxiety disorder?
the focus of anxiety in generalized anxiety disorder is not limited to physical complaints
How can somatization disorder be differentiated from mood disorders (especially depressive disorders)?
in somatization disorder, symptoms persist regardless of mood, while in depressive disorders, the somatic symptoms are generally only experienced during depressive episodes
How can somatization disorder be differentiated from hypochondriasis?
hypochondriasis can not be diagnosed if preoccupation with fears of having a serious illness occurs exclusively during the course of somatization disorder
What is the essential feature of undifferentiated somatoform disorder?
one or more physical complaints (like fatigue, loss of appetite, gastrointestinal, or urinary complaints) that persist for six months or longer
What is the B criterion for undifferentiated somatoform disorder?
Either 1 or 2:
- after appropriate investigation, the symptoms cannot be fully explained by a known general medical condition or the direct effects of a substance
- when there is a related general medical condition, the physical complaints or resulting social or occupational impairment is in excess of what would be experienced from the history, physical examination, or laborotory findings
What are the C and D criteria for undifferentiated somatoform disorder?
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
D. The duration of the disturbance is at least six months
What are the E and F criteria for undifferentiated somatoform disorder?
E. Not better accounted for by another mental disorder (like another somatoform disorder, sexual dysfunction, mood disorder, anxiety disorder, sleep disorder, or psychotic disorder)
F. The symptom is not intentionally produced or feigned (like factitious disorder or malingering)
If symptoms do not meet the full criteria for somatization disorder and have not persisted for six months, what must be diagnosed?
somatoform disorder not otherwise specified
What is the essential feature of conversion disorder?
the presence of symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition
What is criterion B for conversion disorder?
B. Psychological factors are judged to be associated with the symptom or deficit because the initiation or exacerbation of the symptom or deficit is preceded by conflicts or other stressors.
What are criterion C and D for conversion disorder?
C. The symptom or deficit is not intentionally produced (factitious/malingering)
D. Not gen med/substance or a culturally sanctioned behavior or experience
What are criteria E and F for conversion disorder?
E. causes clinically significant distress/impairment (social, occupational, other) or warrants medical evaluation
F. Not limited to pain or sexual dysfunction, does not occur exclusively during course of somatization disorder, and not better accounted for by another mental disorder
What are the subtypes of conversion disorder?
with motor symptom or deficit
with sensory symptom or deficit
with seizures or convulsions
with mixed presentation
When would the subtype "with motor symptom or deficit" be applied to conversion disorder?
This subtype includes such symptoms as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or "lump in throat," aphonia, and urinary retention.
When would the "with sensory symptom or deficit" subtype to conversion disorder be used?
This subtype includes such symptoms as loss of touch or pain sensation, double vision, blindness, deafness, and hallucinations.