Multiple and ill-defined somatic complaints can be classified under
somatoform disorders or neurasthenia (3).
Conversion disorder is a form of
somatoform disorders, a group of disorders with the manifestation of physical symptoms without any underlying physical or organic pathology.
Mood disorders (52%), neurotic, stress-related and
somatoform disorders (33%), and substance related disorders (28%) were the most common disorders.
When you suspect a
somatoform disorder including conversion, start therapy and treat the symptoms as "real." (12) Tell the patient that no specific treatment will completely resolve the symptoms, but that it can help.
Treatment of the patient as a whole, with respect and empathy, as well as frequent follow-up, is the treatment of choice for
somatoform disorders and may be an effective treatment.
Symptoms such as depression, anxiety and cognitive impairment are often present, and the opinion of a psychiatrist may be sought to rule out the presence of a significant psychiatric disorder, including an undifferentiated
somatoform disorder.
if an individual suffering from a
somatoform disorder feels significantly limited in his or her ability to work or function because of the disorder, he or she may choose to file for disability.
A subtype of
somatoform disorder, conversion disorder, has historically been treated in inpatient settings (Speed and Mooney 2002).
Psychopathological symptoms (question a), particularly psychotic and
somatoform disorder symptoms, explained between 8% (Feel like expressing anger verbally) and 23% (Feel like expressing anger physically) of the variance of the various state anger aspects, whilst hostility symptoms alone explained between 9% (Angry temperament, Anger Expression out and in) and 24% (Trait anger) of the same variance.
On Scale-II of SCL-R: Somatoform, a mean score of 15 with a standard deviation of 13 was obtained by non psychiatric sample of Lahore city and the clients who were presenting with somatic complaints and diagnosed as having
Somatoform disorder got a mean score of 54 with a standard deviation of 18.
Co-morbid psychiatric disorders * in adult ADHD subjects (N=25) Co-morbidities Current Lifetime N (%) N (%) Oppositional defiant disorder 6 (24) 1 (4) Major depressive disorder 6 (24) Substance abuse/dependence 5 (20) Social phobia 2 (8) Specific phobia 2 (8) Undifferentiated
somatoform disorder 2 (8) Bipolar affective disorder 2 (8) Obsessive compulsive disorder 2 (8) Pain disorder due to psychological causes 1 (4) Male erectile disorder 1 (4) Generalized anxiety disorder 1 (4) Anti-social personality disorder 1 (4) Multiple co-morbidities 6 (24) 8 (32) * Not mutually exclusive
Multiple medically unexplained symptoms increase the likelihood of a co-existing psychiatric diagnosis, with as many as half of patients having an anxiety disorder, and two-thirds a depressive disorder.3,5,7-9 Moreover, there is some evidence that functional impairment is higher in
somatoform disorder with a co-morbid depressive or anxiety disorder.