Somatic symptom disorder, also known as hypochondriasis, is a condition in which individuals feel extremely distressed about their health and have excessive thoughts, feelings, and behaviors relating to their physical symptoms.
A diagnosis of somatic symptom disorder requires at least one of the following symptoms:
To be classified as a disorder, the symptoms typically persist for more than 6 months, although any one somatic symptom may not be continuously present. Different degrees of somatic symptom disorders may be diagnosed. These include:
Somatic symptom disorder must be differentiated from nonpsychiatric medical conditions, especially disorders that show symptoms that are not easily diagnosed. These include AIDS, endocrinopathies, myasthenia gravis, multiple sclerosis, degenerative diseases of the nervous system, and lupus.
Patients with somatic symptom disorder often resist psychiatric treatment. However, they may accept therapy that focuses on stress reduction and education in coping with chronic illness. Group psychotherapy is often beneficial, in part because of the social support it provides. Other types of therapy that may be helpful include insight-oriented psychotherapy, behavior therapy, cognitive therapy, and hypnosis.
Pharmacotherapy may help treat a person with somatic symptom disorder only when the patient has an underlying drug-responsive condition, such as an anxiety disorder or depressive disorder.
Illness anxiety disorder is a newer diagnosis that applies to individuals who are preoccupied with being sick or with developing a disease of some kind. It is a variant of somatic symptom disorder (hypochondriasis). However, somatic symptoms are either not present, or present at a mild degree. If another medical condition is present or if there is a high risk for developing a medical condition (e.g., strong family history is present) the preoccupation is clearly excessive.
A diagnosis for illness anxiety disorder also requires the following factors:
As with somatic symptom disorder, patients with illness anxiety disorder often resist psychiatric treatment. However, they may accept therapy that focuses on stress reduction and education in coping with chronic illness. Group psychotherapy is often beneficial, in part because of the social support it provides. Other types of therapy that may be helpful include insight-oriented psychotherapy, behavior therapy, cognitive therapy, and hypnosis.
Pharmacotherapy may help alleviate the anxiety generated by the fear the patient has about illness, especially if it is one that is life-threatening.
Conversion disorder, also called functional neurological symptom disorder, is an illness of one or more symptoms that affect voluntary motor functions (e.g., breathing or walking) or sensory functions (e.g., touch, pressure, temperature, pain.)
A diagnosis of conversion disorder requires the following factors:
A diagnosis of conversion order may be specified with any of the following symptom types:
Yes, in fact, there is a diagnosis for “psychological factors affecting other medical conditions.” This diagnosis is given when a medical symptom or condition (other than a mental disorder) is present, with psychological or behavioral factors adversely affecting the medical condition in one of the following ways:
The diagnosis also requires that the psychological and behavioral factors are not better explained by another mental disorder (e.g., panic disorder, major depressive disorder, post-traumatic stress disorder).
Factitious disorder is a mental disorder in which someone deceives others by appearing sick, by purposely getting sick, or by self-injury. Factitious disorder can also happen when a person falsely presents another individual, such as a family member, as being ill, injured or impaired.
Factitious Disorder Imposed on Self
A diagnosis of factitious disorder “imposed on self” is based on:
Factitious Disorder Imposed on Another
A diagnosis of factitious disorder “imposed on another” is based on:
A person be diagnosed with “other specified somatic symptom and related disorder” if the individual has somatic type symptoms that cause significant distress or impairment in social, occupational, or other important areas of functioning but the symptoms do not meet the full criteria for any of the other somatic symptom and related disorders (e.g., illness anxiety disorder, conversion disorder, factitious disorder).
Examples of situations where this “other specified” diagnosis may be used include:
The diagnosis of “other specified somatic symptom and related disorder” may be used if an individual has somatic type symptoms that cause significant distress or impairment in social, occupational, or other important areas of functioning but the symptoms do not meet the full criteria for any of the other somatic symptom and related disorders (e.g., illness anxiety disorder, conversion disorder, factitious disorder). This diagnosis is used only in unusual situations where there is insufficient information to make a more specific diagnosis.