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Illness and Illusion
Published in Marc D. Feldman, Gregory P. Yates, Dying to be Ill, 2018
Marc D. Feldman, Gregory P. Yates
In somatic symptom disorder the symptoms are psychological in origin (psychogenic), but differ from factitious disorder because the patient has no voluntary control over them. No deception is involved. The symptoms are caused by unconscious processes. For these reasons, we would place somatic symptom disorder on the opposite side of our diagram to factitious disorder.
Malingering
Published in Alan R. Hirsch, Neurological Malingering, 2018
Jasmine M. Campbell, Chevelle Winchester, Angela Rekhi, Khurram A. Janjua, Anton N. Dietzen, Alan R. Hirsch
In contrast, somatic symptom disorder presents in a psychologically unwell patient who unconsciously feigns symptoms with no physical cause; complaints are often multiple, vague, and span multiple organ systems. Conversion disorder may be thought of as an extreme of somatic symptom disorder in which a stressor often precipitates a significant sensory or neurological symptom, which cannot be explained by a neurological disease or another medical condition. Factitious disorders are similar to malingering in that patients are pursuing a goal, particularly attention or sympathy from doctors, friends, or family rather than financial secondary gain. Patients having psychiatric involvement and behavior is deliberate. However, unlike malingering, these individuals are often willing to undergo painful/dangerous tests or treatments. Lastly, illness anxiety disorder can be observed in patients who are psychologically unwell, where they genuinely believe they may be affected by a condition but seek no intrinsic or extrinsic gain. Malingerers, compared to the aforementioned disorders, consciously seek extrinsic gain.
Placebo for Psychogenic Disorders
Published in L. Syd M Johnson, Karen S. Rommelfanger, The Routledge Handbook of Neuroethics, 2017
Lindsey Grubbs, Karen S. Rommelfanger
Because of the perception that these conditions have psychological roots, patients are often passed to psychiatrists, despite evidence that such disorders can occur without comorbid psychiatric diagnoses (Factor et al., 1995;Gupta and Lang, 2009). In psychiatric terms, conversion disorder (also known in the most recent iteration of the Diagnostic and Statistical Manual [DSM] as “functional neurological symptom disorder”) is characterized by neurological symptoms, like blindness, paralysis, seizure, or abnormal movement, that are inconsistent with organic neurological conditions. Somatoform and somatization disorders have long been the diagnostic terms for MUPS, but while somatization disorder persists as a diagnosis in ICD-10, it has been removed in the most recent version of the DSM. In the DSM-5, somatization disorder, hypochondriasis, pain disorder, and undifferentiated somatoform disorder have been replaced by “somatic symptom disorder.” Importantly, the diagnostic criteria stress that the symptoms need not be medically unexplained to qualify—they need only disrupt daily life and be characterized by “excessive” thoughts and feelings. Hence, not all patients with MUPS or psychogenic disorders qualify for this kind of psychiatric diagnosis, nor does an organic disorder preclude it (APA, 2013a).
Brief Report: Child Sexual Abuse and Somatic Symptoms in Older Adulthood for Men
Published in Journal of Child Sexual Abuse, 2022
Scott D. Easton, Jooyoung Kong, Samantha M. McKetchnie
Introduced in the fifth edition of the Diagnostic Statistical Manual (DSM-5), somatic symptom disorder is characterized by physical symptoms that result in significant distress and interruptions in daily functioning (American Psychological Association, n.d). Prevalence rates vary greatly across countries, cultures, and communities (Alkhadhari et al., 2016; Easton et al., 2022; Nazzal et al., 2021). In the United States, 5–7% of the individuals in the general population meet criteria for somatic disorders (Kurlansik & Maffei, 2016). These disorders are more prevalent in women and younger adults, with men ten times less likely to receive an official diagnosis (Kurlansik & Maffei, 2016). Furthermore, older adults are often misdiagnosed due to symptom overlap with diseases of aging (Van Driel et al., 2018). Somatic disorders exact a tremendous toll on the individual, but also involve high societal costs (e.g., overutilization of healthcare services, unneeded testing, or treatment; Croicu et al., 2014; Puri & Dimsdale, 2011).
Development of the Body-Relatedness Observation Scale: A feasibility study
Published in Physiotherapy Theory and Practice, 2022
Hanneke Kalisvaart, Saskia van Broeckhuysen-Kloth, Jooske T. van Busschbach, Rinie Geenen
This study was conducted at a tertiary mental health center, specializing in the treatment of somatoform disorder and somatic symptom disorder. Patients admitted to this institution have had somatic symptoms on average for 10 years, have received about 5 previous treatments for somatoform disorder in primary or secondary care and have a comorbid mood, anxiety, or personality disorder in about half of the cases (Van der Boom and Houtveen, 2014). People referred to treatment for somatoform disorder completed self-report questionnaires and were assessed by a physical therapist as part of the diagnostic procedure. At the time of data collection in this study, somatoform disorder was diagnosed by trained psychologists according to DSM-IV-TR criteria (American Psychiatric Association, 2000) and confirmed by the resident medical doctor and psychiatrist.
Relationships between chronic pain with locomotive syndrome and somatic symptom disorder in general community-dwelling population: A cross-sectional evaluation of individuals aged 50 years or older undergoing primary specific health screening
Published in Modern Rheumatology, 2020
This study is not without limitations. First, on average 51% of a target population in Japan undergo specific health checkups; this percentage is a higher figure than that achieved in this survey, since interview sheets were retrieved from only 34.6%. Therefore, the survey results may have been biased as, for example, the study population might be overrepresented by individuals who are interested in health. Second, the present survey was conducted in Asahimachi, where individuals aged ≥65 years account for more than 41% of the population. Accordingly, individuals undergoing health checkups include many elderly individuals, and therefore might skew the population distribution. However, in Japan where the population is rapidly aging, an increasing number of towns are anticipated to have a high percentage of elderly residents, and we foresee potential opportunities for utilizing data obtained from this study. Third, this study was aimed at the general community residents arriving for health checkups, and therefore, screening tools used were simple and easy to respond, even for individuals aged 50 years or older. Among the tools, Loco-check and SSS-8 were used for primary screening for LS and somatic symptom disorder and therefore, an overestimation is plausible. Furthermore, we could not determine the threshold of SSS-8 for somatic symptom disorder. Therefore, somatic syndrome disorder was evaluated using presence/absence of SSS-8. This analysis may overestimate the prevalence of somatic symptom disorder. Lastly, the English version of MBM used in this study has been validated, but not the Japanese version. Thus, the small number of individuals complaining of lower back pain might have been due to many respondents describing it as buttock pain. Therefore, the Japanese version needs to be validated for use in future studies.