SOMATOFORM DISORDERS ILLNESS ANXIETY DISORDER

 Formerly "Hypochondriasis" is preoccupation with the

INTRODUCTION fear that one has a serious disease( disease conviction)
 In the early 1800's, the medical field began to consider the or will get a serious disease( disease phobia)
various social and
 psychological factors that influence illness. BODY DYSMORPHIC DISORDER
 The term "psychosomatic" began to be used to convert  Preoccupation with some imagined defect in appearance
connection between the mind(psyche) and the body (soma) in a normal-appearing person.
in states of health and illness.
 Hysteria - refers to multiple physical complaints with ONSET AND COURSE
no organic basis; associated with witchcraft, demons, Somatic Symptom Disorder:
sorcerers.; usually women possessed with evil spirits.  often experience symptoms in adolescence, though
these diagnoses may not be made until early adulthood
DISCOVERER: 9 (25 years of age)
 Paul Briquet And Jean-Martin Charcot-both French  Seek help from mental health professionals after
physicians exhausting all efforts at finding a diagnosed medical
 Sigmund Freud-observed that people with hysteria condition.
improved with hypnosis and experienced relief from  Tends to go from one physician to another; tends to be
their physical symptoms when they recalled memories pessimistic about the medical establishments.
and expressed emotions. Conversion disorder: Occurs between ages of 10 and 35 yrs.
Pain and illness disorder: Can occur at any age; are unlikely to
SOMATIZATION receive treatment in mental health settings unless with comorbid
 converting unexpressed emotions into physical condition.
symptoms.
 defined as the transference of mental experiences and RELATED DISORDERS
states into bodily symptoms.
 somatic symptom is characterized as the presence of MALINGERING AND FACTITIOUS DISORDER
physical symptoms that suggest medical condition  Also known as " fabricated or induced illness"
without a demonstrable organic basis.  People feign or intentionally produce symptoms for some
purpose or gain.
THREE CENTRAL FEATURES:  Tends to willfully control the symptoms
1. Physical complaints suggest major medical illness but
have no demonstrable organic basis.  Malingering - is the intentional production of false or
2. Psychological factors and conflicts seem important grossly exaggerated physical or psychological
initiating, exacerbating and maintaining the s/s symptoms
3. Symptoms or magnified health concerns are not under  motivated by external incentives as avoiding
the client's conscious control. work, evading criminal prosecution, obtaining
financial compensation or obtaining drugs.
SOMATIZATION DISORDER  Factitious disorder
 Characterized by one or more physical symptoms that have  occurs when a person intentionally produces or
no organic basis. feign physical and psychological symptoms
 Individuals spend a lot of time and energy focused on solely to gain attention.
health concerns, often believing symptoms to indicate  they may even inflict injury on themselves to
serious illness and experience significant distress and receive attention. the common term is
anxiety about their health. Munchausen Syndrome
 Has 4 pain symptoms  Munchausen syndrome by proxy - when a
 2 Gastrointestinal symptoms person inflicts injury to another person to gain
 1 sexual symptoms attention and be a "hero" for saving the victim.
 1pseudoneurological symptoms
MEDICALLY UNEXPLAINED SYMPTOMS(MUS) and
CONVERSION DISORDER FUNCTIONAL SOMATIC SYNDROMES
 Sometimes called conversion reaction, involves  They refer to physical symptoms and limitations of
unexplained, usually sudden deficits in sensory or motor function that has no medical diagnoses to explain their
function(blindness, paralysis). existence.
 An unconscious process through which the anxiety is  More acceptable to the patient because it doesn't have
converted into physical and physiologic symptoms. the connotation of "it's all in your head" as do
 These deficits suggest a neurologic disorder but are psychosomatic descriptors.
associated with psychological factors.  Treatment: being listened and heard; learning to cope
 There may be a "La belle indifference" - a lack of with symptoms; learning to ignore some symptoms;
concern or distress, about the functional loss. positive response an support from providers.

PAIN DISORDER
 Has the primary physical symptom of pain, which is
generally unrelieved by analgesics and greatly affected
by psychological factors in terms of onset, severity,
exacerbation and maintenance.
 ETIOLOGY
 PSYCHOSOCIAL THEORIES
 Believe that people with somatic symptom keep stress,
anxiety or frustration inside rather than expressing
outwardly.
 Also called internalization
 Client's with somatic symptom uses internalization and
somatization as chief defense mechanisms.
 Have tremendous difficulty dealing with interpersonal
conflict.
 The worsening of physical symptoms helps them meet
psychological needs for security, attention and
affection.
 Somatization - often associated with women, old
term," hysteria"
 BIOLOGICAL THEORIES
 These clients cannot sort relevant from irrelevant
stimuli and respond equally to both types.
 They may experience a normal body sensation such as
peristalsis and attach pathologic rather than a normal
meaning to it.

TREATMENT
• Focuses on managing symptoms and improving quality of life.

PHARMACOLOGIC:
 Antidepressants- such as SSRI (Prozac); (Zoloft) and
(Paxil) are most commonly used.
 Avoid administering narcotic analgesics because of the
risk of dependence or abuse.
 NSAIDS can help reduce pain.
 For clients with pain disorder, referral to a chronic pain
clinic may be useful.- doing visual imaging and
relaxation

NURSING INTERVENTION
 Involves providing health teaching
 Identifying emotional feelings and stress
 Using alternative coping strategies.

 Coping strategies -relaxation techniques such as guided

imagery and deep breathing; distractions such as music;
problem-solving strategies such as identifying stressful
situations, learning new methods and managing them and
role-playing social interactions.