Somatoform Disorder
Definition:
Somatoform disorder is a syndrome of prolonged physical symptoms in the absence of an identifiable organic cause with associated functional impairment in the context of an identifiable stressor. [1]
The somatoform disorders are characterised by repeated presentation with physical symptoms which do not have any adequate physical basis, and a persistent request for investigations and treatment despite repeated assurances by the treating doctors. [2]
Somatoform disorder, as a term, is outdated. It has been replaced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) with Somatic Symptom Disorder (SSD). However, some older sources might still use the term
Here are some synonyms or related terms:
- Somatic Symptom Disorder (SSD): This is the current and preferred term for the condition, characterized by excessive worry and distress over physical symptoms.
- Medically Unexplained Symptoms (MUS): Refers to physical symptoms that cannot be fully explained by a medical condition.
- Psychogenic illness: This term suggests that the symptoms are primarily caused by psychological factors.
- Functional disorder: This term implies that the symptoms are caused by a disturbance in the function of the body rather than a structural abnormality.
- Psychosomatic disorder: A broader term that refers to any condition in which psychological factors play a significant role in the development or worsening of physical symptoms.
It’s important to note that not all medically unexplained symptoms are due to a somatic symptom disorder. There are many other possible causes, including rare or undiagnosed medical conditions. Therefore, a thorough medical evaluation is always necessary before diagnosing SSD.
Overview
Epidemiology
Causes
Types
Risk Factors
Pathogenesis
Pathophysiology
Clinical Features
Sign & Symptoms
Clinical Examination
Diagnosis
Differential Diagnosis
Complications
Investigations
Treatment
Prevention
Homeopathic Treatment
Diet & Regimen
Do’s and Don'ts
Terminology
References
Also Search As
Overview
Overview of Somatoform Disorder:
People with somatoform disorder have a number of different symptoms that typically last for several years.
Their symptoms can’t be traced to a specific physical cause. In people with somatoform disorder, medical test results are either normal or do not explain the person’s symptoms.
People who have somatoform disorder often become very worried about their health because they do not know what is causing their health problems.
The symptoms of somatoform disorder are similar to the symptoms of other illnesses.
People with this disorder may have several medical evaluations and tests to be sure that they do not have another illness. [3]
Epidemiology
Indian epidemiology of Somatoform disorder:
Prevalence: Studies suggest a prevalence of around 5% for Somatization Disorder at quaternary mental health centers in India.
Correlates: The condition is significantly associated with:
- Median age of 40.5 years
- Female gender
- Married status
- Less than 5 years of education
- Monthly income less than ₹ 10,357
- Lower socioeconomic status.[4]
Causes
Causes of Somatoform Disorder:
The cause is not known.
In some cases, there may be a problem with the nerve impulses that send signals of pain, pressure also other unpleasant sensations to the brain.
We do know that the pain also problems caused by somatoform disorder are real.
Like many medical problems, somatoform disorder often runs in families. It tends to come and go over time. [3]
Types
Types of Somatoform Disorders
Somatoform disorders encompass a range of mental health conditions characterized by physical symptoms that cannot be fully explained by a general medical condition, substance use, or another mental disorder.
The distress and impairment caused by these symptoms are significant. While the exact diagnostic criteria have evolved over time, here are some commonly recognized types of somatoform disorders:
Somatic Symptom Disorder:
- This disorder involves one or more persistent physical symptoms (e.g., pain, fatigue, gastrointestinal issues) that cause significant distress or impairment in daily life.
- Individuals with this disorder often have excessive thoughts, feelings, or behaviors related to their symptoms, leading to frequent doctor visits and medical testing.
Illness Anxiety Disorder:
- Previously known as hypochondriasis, this disorder is characterized by a preoccupation with having or acquiring a serious illness.
- Individuals may misinterpret normal bodily sensations or minor symptoms as signs of a severe disease, leading to anxiety and excessive health-related behaviors.
Conversion Disorder:
- This disorder involves neurological symptoms (e.g., paralysis, blindness, seizures) that cannot be explained by a neurological condition.
Psychological Factors Affecting Other Medical Conditions:
- This diagnosis applies when psychological or behavioral factors adversely affect a diagnosed medical condition.
- For example, stress may worsen asthma symptoms or anxiety may exacerbate heart problems.
Factitious Disorder:
- In this disorder, individuals intentionally feign or induce physical or psychological symptoms to assume the sick role.
- They may go to great lengths to deceive others, even undergoing unnecessary medical procedures.
It’s important to note that somatoform disorders are complex and can be challenging to diagnose. If you’re experiencing unexplained physical symptoms that are causing significant distress, it’s important to seek professional evaluation from a qualified mental health provider or physician. They can help rule out any underlying medical conditions and provide appropriate treatment and support.
Risk Factors
Risk factors of Somatoform Disorder
Temperamental:
- Negative affectivity (neuroticism): This refers to a tendency to experience negative emotions such as anxiety, worry, and sadness. Individuals with high negative affectivity may be more likely to misinterpret bodily sensations and develop somatic symptoms.
Environmental:
- Stressful life events: Experiencing significant stress or trauma can increase the risk of developing a somatoform disorder.
- Childhood adversity: Exposure to abuse, neglect, or other forms of adversity during childhood can also contribute to the development of these disorders.
- Reinforcement of illness behavior: If individuals receive attention or sympathy for their physical symptoms, it can inadvertently reinforce their illness behavior and make it more likely to persist.
Genetic and physiological:
- Family history of somatic symptom and related disorders: There is evidence to suggest that these disorders may have a genetic component.
- Increased sensitivity to pain: Individuals who are more sensitive to pain may be more likely to experience somatic symptoms.[5]
Pathogenesis
Pathogenesis of Somatoform Disorder
Cognitive factors:
- Catastrophize bodily sensations, interpreting them as signs of serious illness.
- Have a heightened attentional focus on bodily sensations, leading to increased awareness of even minor physical changes.
- Engage in selective attention to illness-related information, reinforcing their beliefs about having a serious medical condition.
Behavioral factors:
- Illness behavior can be reinforced if individuals receive attention or sympathy for their physical symptoms.
- Avoidance behavior can develop, as individuals may avoid activities they believe will exacerbate their symptoms.
Neurobiological factors:
- There is evidence to suggest that altered pain processing may play a role in some somatoform disorders.
- Dysregulation of the stress response system may also contribute to the development of these conditions.
Early life experiences:
- Childhood adversity such as abuse or neglect can increase the risk of developing somatoform disorders later in life.
- Learning from family members or significant others who express distress about physical symptoms can also shape an individual’s beliefs and behaviors.[5]
Pathophysiology
Pathophysiology of Somatoform Disorder
The precise pathophysiology of somatoform disorder remains an area of active research and is not fully understood. It is likely a multifactorial condition involving a complex interaction of biological, psychological, and social factors.
Biological Factors:
- Altered pain perception: Individuals with somatoform disorders might have heightened sensitivity to pain or a lower pain threshold.
- Neurotransmitter dysregulation: Imbalances in neurotransmitters, particularly serotonin and dopamine, might contribute to the development of somatic symptoms.
- Stress response dysregulation: Chronic stress and an overactive stress response system might contribute to physical symptoms.
Psychological Factors:
- Cognitive biases: Catastrophizing, selective attention to bodily sensations, and misinterpretation of normal physiological functions can play a role.
- Alexithymia: Difficulty identifying and expressing emotions might lead to the somatization of emotional distress.
- Early life experiences: Childhood trauma or adversity can increase the risk of developing somatoform disorders later in life.
Social Factors:
- Reinforcement of illness behavior: Attention and sympathy for physical symptoms can inadvertently reinforce and perpetuate them.
- Cultural factors: Certain cultures might stigmatize mental illness, leading to the expression of psychological distress through physical symptoms.
Theoretical Models:
- Cognitive-Behavioral Model: This model focuses on the role of cognitive distortions and maladaptive behaviors in the development and maintenance of somatoform disorders.
- Psychodynamic Model: This model emphasizes the role of unconscious conflicts and early childhood experiences in the development of physical symptoms.
- Neurobiological Model: This model focuses on the role of neurotransmitter dysregulation, altered pain perception, and stress response dysfunction in the development of somatoform disorders.[5]
Clinical Features
Clinical Features of Somatoform Disorder
Specific clinical features can vary depending on the specific type of somatoform disorder, but common features include:
- Persistent physical symptoms: These symptoms can involve any part of the body and may include pain, fatigue, gastrointestinal problems, or neurological symptoms.
- Excessive thoughts, feelings, or behaviors related to the symptoms: Individuals may have persistent thoughts about the seriousness of their symptoms, high levels of anxiety about their health, or excessive time and energy devoted to health concerns.
- Significant distress or impairment: The symptoms cause significant emotional distress or interfere with daily functioning, such as work, school, or relationships.
Additional clinical features that may be present in some cases include:
- Multiple somatic symptoms: Some individuals may experience a variety of different physical symptoms.
- Long duration of symptoms: Symptoms may persist for months or even years.
- History of multiple medical evaluations: Individuals may have a history of seeking medical care from multiple providers without a clear diagnosis or effective treatment.
- Comorbid mental health conditions: Somatoform disorders often co-occur with other mental health conditions, such as anxiety disorders or depression.
It is important to note that:
- The clinical presentation of somatoform disorders can vary widely.
- A thorough evaluation by a qualified mental health professional is essential for accurate diagnosis and treatment.
Sign & Symptoms
Sign & Symotptoms of Somatoform Disorder:
Symptoms may include:
- Frequent headaches
- Back pain
- Abdominal cramping
- Pelvic pain
- Pain in the joints, legs and arms, also chest
- Abdominal pain
- Gastrointestinal problems i.e.:
- Sometimes somatoform disorder makes it painful for a person to urinate, even if they doesn’t have an infection. [3]
Clinical Examination
Clinical Examination for Somatoform Disorder
- Thorough medical history, including detailed symptom descriptions and timeline.
- Exploration of psychosocial factors, stressors, and past trauma.
- Assessment of mental health, including anxiety and depression screening.
- Physical examination to rule out underlying medical conditions.
Key Points:
- Patient-centered approach: Empathetic listening, validation of concerns.
- Open-ended questions: Encourage elaboration on symptoms and experiences.
- Mental status examination: Evaluate cognitive function, mood, and thought processes.
- Collaboration: Involve the patient in treatment planning and decision-making.[5][6].
Diagnosis
Diagnosis of Somatoform Disorder
One or more somatic symptoms that are distressing or result in significant disruption of daily life.
Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:
- Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
- Persistently high level of anxiety about health or symptoms.
- Excessive time and energy devoted to these symptoms or health concerns.
State of being symptomatic is persistent (typically more than 6 months), though any one specific symptom may not be continuously present.
Additional Considerations:
- Rule out other medical conditions: It is crucial to conduct a thorough medical evaluation to ensure that the symptoms are not attributable to another underlying medical or neurological disorder.
- Specify if:
- With predominant pain: If pain is the predominant symptom.
- Persistent: If the course is persistent (more than 6 months) and severe.
- Current severity: Specify current severity as mild, moderate, or severe based on the number of symptoms and level of functional impairment.
Important Note: The diagnosis of SSD emphasizes the psychological distress and preoccupation associated with the somatic symptoms rather than the presence or absence of a medical explanation for the symptoms.
Differential Diagnosis
Differential Diagnosis of Somatoform Disorder
Medical Conditions: It is crucial to rule out any underlying medical or neurological conditions that may be causing the somatic symptoms. This involves a thorough medical evaluation, including physical examination, laboratory tests, and imaging studies if necessary.
Illness Anxiety Disorder: In this disorder, the primary concern is the fear of having or acquiring a serious illness, despite the absence of significant somatic symptoms.
Conversion Disorder (Functional Neurological Symptom Disorder): This involves neurological symptoms (e.g., paralysis, blindness) that are incompatible with recognized neurological or medical conditions and are often associated with psychological stressors.
Psychological Factors Affecting Other Medical Conditions: In this case, a diagnosed medical condition is present, but psychological or behavioral factors adversely affect its course, treatment, or management.
Factitious Disorder: This involves the intentional feigning of physical or psychological symptoms to assume the sick role, without any external incentives.
Malingering: In malingering, there is an intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives (e.g., avoiding work, obtaining financial compensation).
Body Dysmorphic Disorder: This involves a preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
Depressive and Anxiety Disorders: These disorders can often present with somatic symptoms, such as fatigue, pain, or gastrointestinal complaints. It is important to assess for the presence of core mood or anxiety symptoms.
Obsessive-Compulsive Disorder (OCD): Repetitive thoughts and behaviors centered on health concerns or bodily sensations can sometimes be part of OCD.[5]
Complications
Complications of Somatoform Disorder
Impaired Functioning:
- The excessive preoccupation with somatic symptoms and health concerns can lead to significant disruptions in daily life, including difficulties with work, school, relationships, and social activities.
- The individual may experience physical disability or limitations due to their perceived symptoms, even in the absence of a clear medical explanation.
Comorbid Mental Health Conditions:
- SSD is often associated with other mental health disorders, such as anxiety disorders, depressive disorders, and personality disorders.
- The presence of comorbid conditions can further complicate the clinical picture and necessitate a comprehensive treatment approach.
Increased Healthcare Utilization:
- Individuals with SSD may frequently seek medical attention and undergo numerous tests and procedures, even when previous evaluations have not revealed any underlying medical cause for their symptoms.
- This can lead to unnecessary healthcare costs, potential iatrogenic harm from interventions, and frustration for both patients and healthcare providers.
Strained Relationships:
- The persistent focus on somatic symptoms and health concerns can strain relationships with family, friends, and significant others.
- Loved ones may become frustrated or feel helpless in the face of the individual’s ongoing distress and preoccupation with their symptoms.
Social Isolation:
- The fear of judgment or disbelief from others can lead to social withdrawal and isolation.
- The individual may avoid social situations or activities due to concerns about their symptoms or fear of being perceived as "sick" or "attention-seeking."
Financial Difficulties:
- The costs associated with frequent medical appointments, tests, and treatments can lead to financial strain.
- Additionally, the individual may experience difficulty maintaining employment due to their impaired functioning and frequent medical absences.
Suicide Risk:
- In severe cases, particularly when accompanied by comorbid depression, individuals with SSD may be at an increased risk for suicidal thoughts or behaviors.[5]
Investigations
Investigations of Somatoform Disorder
The primary focus in investigating Somatoform Disorder, now referred to as Somatic Symptom Disorder (SSD) in DSM-5, is to rule out any underlying medical conditions that may be causing the somatic symptoms.
1. Thorough Medical History and Physical Examination:
- A detailed medical history, including a comprehensive review of systems, is essential to identify any potential medical explanations for the patient’s symptoms.
- A thorough physical examination is performed to assess for any physical signs or abnormalities that may suggest an underlying medical condition.
2. Laboratory and Imaging Studies:
- The specific tests ordered will depend on the patient’s presenting symptoms and medical history.
- Common investigations may include:
- Blood tests: Complete blood count, comprehensive metabolic panel, thyroid function tests, erythrocyte sedimentation rate, C-reactive protein, vitamin B12 levels, etc.
- Urine analysis
- Imaging studies: X-rays, CT scans, MRIs, or other imaging modalities as indicated by the patient’s symptoms.
3. Psychological Assessment:
- A mental health professional will conduct a comprehensive psychological assessment to evaluate the patient’s thoughts, feelings, and behaviors related to their somatic symptoms.
- This may involve the use of standardized questionnaires or screening tools to assess for the presence of anxiety, depression, or other mental health conditions.
4. Collateral Information:
- Gathering information from family members or other significant individuals can provide valuable insights into the patient’s symptom history, functional impairment, and psychosocial stressors.
Important Considerations:
- The extent of investigations should be guided by the patient’s clinical presentation and the index of suspicion for underlying medical conditions.
- Over-investigation and unnecessary testing should be avoided, as they can reinforce the patient’s preoccupation with somatic symptoms and contribute to iatrogenic harm.
- A collaborative approach between medical and mental health professionals is essential to ensure appropriate and comprehensive assessment.
Treatment
Treatment
The goal in treating somatoform disorder is for a person to be able to live a normal life as much as possible, even though they may still have some pain or other symptoms.
Although there is no known cure, it can be managed.
You may be able to prescribe medicine for some of the symptoms, but in many cases you will not need medicine.
Furthermore, The most important part of the treatment is to call the patient for regular checkups.
Besides this, Patients have to know that how often they needs to see the physician.
They may feel frustrated if their symptoms continue, but remember that somatoform disorder can be very difficult to treat.
Inpatient care:
If your condition is deemed particularly severe, then you may decide that a structured treatment approach, which can include staying at one of the Priory hospitals for the duration of their treatment, would be more effective.
Inpatient treatment allows you to take part in a psychological group programme as well as regular sessions with your consultant.
In terms of the specific treatment options that used, psychotherapy, also known as ‘talk therapy’, is believed to be particularly helpful when trying to improve daily functioning.
Cognitive behavioural therapy (CBT):
CBT is a commonly used talking therapy, which is an action-based therapeutic method that helps you to understand the condition. [3]
Prevention
Prevention of Somatoform Disorder
While there is limited research on specific preventative measures for Somatoform Disorder, certain strategies and recommendations may help reduce the risk of its development or minimize its severity:
Early intervention: Addressing any underlying mental health concerns, such as anxiety or depression, as soon as possible can be crucial.
Stress management: Developing healthy coping mechanisms and stress reduction techniques can help individuals better manage emotional distress, potentially reducing the risk of somatic symptoms.
Mind-body connection: Enhancing awareness of the mind-body connection can help individuals recognize how emotional states can influence physical sensations.
Additional Recommendations:
- Psychoeducation: Providing information and education about the interplay between physical and psychological health may promote understanding and reduce stigma associated with Somatoform Disorder.
- Healthy lifestyle: Encouraging regular exercise, adequate sleep, and balanced nutrition can contribute to overall well-being and resilience.
- Supportive relationships: Fostering strong social connections and support networks can offer emotional support and reduce feelings of isolation.[6]
Homeopathic Treatment
Homoeopathic Treatment
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.
which includes
- The medical history of the patient,
- Physical and mental constitution,
- Family history,
- Presenting symptoms,
- Underlying pathology,
- Possible causative factors etc.
A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.
What Homoeopathic doctors do?
A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.
The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.
The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.
Homeopathic Medicines:
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy.
Some useful homeopathic remedies in Somatoform Disorder are:
Ignatia:
Ignatia is the great homoeopathic remedy for lagrande nevrose. In its proving it is a hysteria remedy.
Briefly, its symptoms are great sensitiveness to external impressions. Patients laugh and cry alternatively, the face flushes on the slightest emotion, spasmodic laughter which oftentimes ends in screaming, the globus hystericus is present and so is the clavus hystericus which shows itself as a sharp pain, as if a nail were being driven into the top of the head.
In Ignatia there is an emission of profuse, pale urine and this oftentimes relieves the headache.
There are, in the Ignatia patient, flatulent conditions also contortion of the muscles. The globus hystericus found under a number of drugs, but Ignatia and Asafoetida have it the most prominent.
The convulsive symptoms of Ignatia are as varied as the moods of the drug; there may be only a slight convulsive movement about the throat in drinking, or there may be severe spasms with clenched hands also blue face greatly resembling those of Cuprum.
Other symptoms
The return to consciousness always accompanied by a sigh and a deep inspiration. Fear also grief are prominent symptoms of the hysteria of Ignatia; it is a long suffering grief and the patient aggravate by the constant nursing of it.
Another interesting and, one may say hysteria point about Ignatia the numerous _ contradictory items found in its pathogenesis. Thus we have headache relieved by stooping, soreness of the teeth better by eating, sore throat better from swallowing, fever without thirst and chilliness relieved especially by uncovering.
cough
The cough even contradictory, for the more the patient coughs the more he wants to cough, also it only stop by an effort of the will.
In fact, the Ignatia patient is very much like what Sir James Paget described hysteria to be, namely: It says ‘I cannot.’ ‘I will not;’ but it really is ‘I cannot will.’ Richet says, "all mediums chose among the grandes hysteriques."
Asafoetida:
In Somatoform disorder Asafortida, One of the characterizing features of hysteria is the globus hystericus, or the sensation of a ball in the throat. Asafoetida has this symptom very prominently.
It seems with this drug to be a sort of reversed. peristalsis and it is especially the remedy if the nervous symptoms· were in any way due to the checking of habitual discharges.
Another important symptom of Asafoetida is the accumulation of flatus in the abdomen; it passes upwards and causes oppressed breathing.
Owing to this the symptom found that this ball-like sensation above referred, starts from the stomach and rises to the throat, and it naturally made worse by overeating and by motion.
Other symptoms
It is a bursting feeling, as if everything would come out of the mouth. Hysteria colic is, therefore, well met by Asafoetida. With Asafoetida the patient swallows continually to keep the lump down, and this gulping adds to the difficulty in breathing.
There is a great deal of restlessness and anxiety with Asafoetida and a changeable mental condition. The muscles jerk and twitch. The entire system is over-sensitive.
Hysteria convulsions due to suppression of discharges will often indicate Asafoetida. Predominance of the throat symptoms should lead one to think always of Asafoetida.
Moschus:
Fainting is the great keynote of Moschus. When hysteria attacks are found with fainting, other drugs may be indicated. Asafoetida may be indicated, Cocculus, Ignatia or Nux moschata, but in most cases Moschus will be the simillimum, so can be think for Somatoform disorder.
It is especially the remedy for the paroxysm. The stimulation of tetanic spasms, the unconsciousness or frequent swooning will point to Moschus. Hughes says no remedy is as good as Moschus for this condition, and Dr J. Heber Smith termed it an indispensable remedy in hysteria.
Muscular twitchings are present and violent spasm or constriction of the chest. She may even turn blue in the face, foam at the mouth and be chilly.
Other symptoms
Moschus, too, has a profuse discharge of pale urine, the globus hystericus, headache and flatulent symptoms. Often the fainting and loss of consciousness will apparently be due to the pressure of gas on the solar plexus of the sympathetic; violent eructations of gas occur in these cases and relieve.
Uncontrollable laughter is also a symptom of Moschus, also the alternate moods of joyfulness and sadness. Sexual desire is increased and symptoms of Nymphomania or Satyriasis may be present.
Hysteria
Hysteria attacks or hiccough may be seen in Moschus, and in the loud eructations in nervous hysteria people it is said to be our best remedy. A mental condition of Moschus is a tendency to scold and the patient scolds himself into a fit.
To sum up, Moschus is indicated by the fainting, by the suffocative attacks by the crying and laughing, globus hystericus, profuse pale urine, and by the sudden attacks of unconsciousness.
It suits in many instances the symptoms, which precede hysteria such as an irritable weakness. Castoreum may benefit those who are on the borderland of hysteria.
Tarentula:
Among the animal remedies- and they are all great producers of nervous symptoms-the spider poisons stand first in the production of symptoms simulating hysteria. Perhaps the most marked of these is the Tarentula Hispana, not the Tarentula Cubensis, which is the carbuncle remedy, but the Spanish spider.
This remedy is useful in hysteria; the paroxysms are apt to feigned, and the patient has immoderate attacks of uncontrollable laughter. The most prominent symptom of the drug, however, is restlessness and trembling of the limbs; the patient compell to keep continually on the move.
There is excessive hyperaesthesia, the spine is sensitive, the ovaries are sensitive, and there is apt to nymphomania. It has found useful in hystero-epilepsy, which, by the way, is quite a rare affection.
Other symptoms
Theridion and Mygale are two of the spider poisons, which may found useful in hysteria conditions; the great predominating sensitiveness to noise will call Theridion to mind, and the chorea-like twitchings will suggest Mygale.
The constant motion of the extremities will easily recognize Tarentula perhaps by the fact that music soothes, by a constrictive headache, and by the feigned fits of uncontrollable laughter.
Platinum:
For Somatoform Disorder, Platinum has an altogether different form of hysteria than of the animal poisons, and it is quickly and easily characterized by its haughty mental condition. Self-esteem is prominent, and she looks down on everyone.
No other drug, in the Materia Medica, has this symptom as prominent as Platinum. There are also paroxysms of laughter, which are very loud and boisterous; in fact, oftentimes the condition borders on the maniacal. The genital organs are very sensitive; there is apt to titillation, even nymphomania.
It is in these genital cases that it finds its best use. Hysteria spasms will call for Platinum when caused by nervous excitement; there is present constriction of the oesophagus and a suffocative feeling.
Other symptoms
Platinum may easily distinguish from Ignatia by the mental condition above referred to. Ignatia is decidedly undemonstrative, while Platinum is absurdly supercilious.
Melancholic conditions also found under Platinum; the patient is morose and discontented, and has a disposition to weep.
The extreme nervous condition makes her sleepless. Palladium is very similar to Platinum; in many respects it may distinguish by lacking the haughtiness of Platinum and having a tendency to be. continually "slighted."
Valeriana:
Valeriana a remedy largely use in the allopathic school for hysteria, and forms one of the main props of their treatment. As a remedy for hysteria in the homoeopathic sense it has some useful symptoms.
There is a sensation· as if something warm were rising from the stomach; this causes a difficulty of breathing; there is also present fear, tremulousness, and palpitation. With Valeriana there is a general state of nervous excitement; the patient is apt to be joyous, lively, and talkative.
A tendency to flushes of heat is often present. It has also the globus hystericus, and there are many pains stimulating rheumatism. Nervous agitation its most mark symptom, and this together with warm sensation rising from the stomach should distinguish.
The alternations of mood, which are prominent with the remedy, should not overlook. It seems to be the remedy for the hysteria habit.
Nux moschata:
This is also one of our good remedies in hysteria. It is especially adapted to nervous hysteria people who change rapidly from grave to gay, but its great distinguishing features are its sleepiness, its bloating, and its dryness of the mouth.
It has also attacks of fainting; the patient exhaust from the least effort. There is a continued constant nervous tension. The symptoms of bloating, which usually occur after eating.
Other symptoms
Nux moschata also has a dry, nervous, hysteria cough, oppression of the chest and fainting fits. Inclination to faint is quite common with the drug.
Bayes say: "In hysteria, particularly the globus hystericus, few medicines act more promptly." He recommends the 3 to 6 decimal dilutions. He also says: "In violent hysteric attacks a drop of Rubini’s Camphor on a little lump of sugar every five or ten minutes is invaluable." This is probably palliative, as Camphor has no special hysteria symptoms.
Gelsemium:
This remedy has a few marked symptoms, which indicate its usefulness in hysteria. It is especially the remedy in hysteria convulsions with spasms of the glottis.
There is excessive irritability of the mind and body with vascular excitement, semi-stupor with languor and prostration. There is a feeling of a lump in the throat, which cannot swallow, and there is a copious flow of pale nervous urine.
Gelsemium is adapted to both male and female onanists, and corresponds especially to the hysteria of the later class. The rigidity is so characteristic of Gelsemium and usually found in hysteria women who suffer from great nervous excitement, hence the usefulness of that remedy in this condition note.
Other symptoms
Great numbness of the extremities, also fear and apprehension; however, languor and malaise are nearly always present.
This, however, is a common hysteria symptom, and little reliance can place on it as a guide to the remedy. Vesical irritability with constant desire to urinate in hysteria patients well meet by Gelsemium.
Pulsatilla:
The Intense symptoms of Pulsatilla are quite prominent. It has a constriction in the throat; something there seems to impede speech. There is a constant change in the feelings and symptoms of the patient, and here we have again the profuse watery urine.
There is a melancholia, sadness, and weeping; Pulsatilla patient gushes out her grief anywhere, and seeks sympathy and consolation and seems to made better by it.
The open air, of course, relieves the Pulsatilla patient. Menses are scanty, and the patient complains of constant chilliness. Hysteria attacks at puberty may indicate Pulsatilla.
Other symptoms
Fainting fits are common, and there is apt to be suppression of menses as leading up to the nervous attacks.
Sepia, too, is a prominent remedy for hysteria associated with uterine symptoms but it is easily distinguished by the general symptoms.
Apis has hysteria at puberty, with amenorrhoea and awkwardness; patient drops things, is clumsy.
Belladonna:
Belladonna may a remedy in hysteria when there is much boisterous excitement, red flushed face, dilated pupils, and the general symptoms of the drug.
There is a rush of blood to the head during the spasmodic attacks and a wild look.
Hyoscyamus has the desire to uncover and go naked, due to perhaps hyperaesthesia of the skin, the silly laughter and the muscular jerkings; and Stramonium may have its turn when the patient is full of absurd fancies, loquacity, etc., but these remedies are among the infrequent ones in the treatment of hysteria.
Kali phosphoricum:
This remedy, one of the tissue remedies, has found clinically to be one of our good remedies in hysteria. It call for in attacks from sudden or intense emotions, or passions in highly nervous and excitable patients; the globus hystericus is present; there are fits of crying and laughter and yawning.
There may spasms, with unconsciousness. Abdomen, tympanitic and sensitive to slightest pressure. Kali phosphoricum may borne in mind for these symptoms – Nervous dread without any cause, looks on the dark side of everything, sighs and is despondent fidgetiness and trembling.
Other remedies:
Agnus castus may come in where there is lasciviousness. Anacardium, where two wills, one contradicting the other, are present. Cactus has a few Intense symptoms, as sadness, crying without reason, consolation aggravates, love of solitude, fear of death, whole body feels caged in wires.
Cocculus, hyperaesthesia and faintness. Arsenicum, hysteria and dysmenorrhoea. Sticta, hysteria after loss of blood, and Cannabis Indica. "This remedy," says Hale, "is more closely allied to the Intense malady than any drug in our Materia Medica."
Isolated symptoms may call for isolated remedies, and more can be done by treating hysteria and its manifold phases homoeopathically than by all the nervines known. [3]
Diet & Regimen
Diet & Regimen of Somatoform Disorder
There is no specific diet or regimen directly linked to the treatment of Somatoform Disorder itself. However, maintaining a healthy lifestyle can contribute to overall well-being and indirectly support individuals with this condition.
- Focus on addressing any underlying mental health conditions (e.g., anxiety, depression) through appropriate therapies and medications as prescribed by a qualified professional.
- Promote stress reduction techniques (e.g., mindfulness practices, relaxation exercises) and healthy coping mechanisms to manage emotional distress.
- Encourage regular physical activity, balanced nutrition, and adequate sleep to support overall health and well-being.
Additional Considerations:
- While no specific diet is proven to treat Somatoform Disorder, a balanced and nutritious diet can contribute to physical and mental health.
- Avoiding excessive caffeine and alcohol intake is generally recommended as they can exacerbate anxiety and disrupt sleep patterns.
- Engaging in enjoyable activities and hobbies can provide distraction and promote a sense of purpose and fulfillment.
Important Note:
- The focus of treatment for Somatoform Disorder is primarily on addressing the underlying psychological factors contributing to the physical symptoms.
- Psychotherapy, particularly cognitive-behavioral therapy (CBT), is often the primary treatment modality to help individuals identify and change unhelpful thought patterns and behaviors.
- It is crucial to consult with a qualified mental health professional for a comprehensive assessment and personalized treatment plan.[6]
Do’s and Don'ts
Do’s and Don’ts
Somatoform Disorder do’s and don’ts
Do’s:
- Validate their feelings. People with Somatoform Disorder are experiencing real distress, even if the physical symptoms don’t have a clear medical cause. Dismissing their concerns can worsen their anxiety and isolation.
- Show empathy and support. Let them know you understand they’re suffering and you believe their experiences are genuine. Offer reassurance and a listening ear.
- Encourage professional help. Gently suggest seeking evaluation from a mental health professional specializing in Somatoform Disorder. Explain that therapy can help manage symptoms and improve quality of life.
- Focus on coping skills. Help them develop healthy ways to manage stress and anxiety, which can often exacerbate physical symptoms. This might include mindfulness, relaxation techniques, or exercise.
- Promote self-care. Encourage healthy habits like good sleep, balanced nutrition, and regular physical activity to support overall well-being.
- Be patient and understanding. Recovery from Somatoform Disorder takes time and effort. Offer ongoing support and understanding throughout their journey.
Don’ts:
- Dismiss or minimize their symptoms. Avoid saying things like "It’s all in your head" or "Just relax and you’ll feel better." This invalidates their experiences and can be extremely hurtful.
- Push for unnecessary medical tests. While initial medical evaluations are important to rule out physical causes, excessive testing can reinforce the belief that something is physically wrong and lead to further anxiety.
- Enable avoidance behaviors. It’s important to encourage gradual re-engagement in activities they may be avoiding due to their symptoms.
- Focus solely on physical symptoms. While addressing physical discomfort is important, it’s equally crucial to address the underlying emotional distress and develop coping mechanisms.
- Give up on them. Recovery is possible with appropriate treatment and support. Continue to offer encouragement and understanding even during setbacks.
Terminology
Terminology
Somatoform Disorder: An outdated term, previously used to describe a group of mental disorders characterized by physical symptoms that cannot be fully explained by a general medical condition, another mental disorder, or the effects of a substance.
Somatic Symptom Disorder: The current diagnostic term used in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) to encompass conditions where individuals experience distressing physical symptoms and exhibit excessive thoughts, feelings, or behaviors related to those symptoms.
Conversion Disorder (Functional Neurological Symptom Disorder): A specific type of somatic symptom disorder where individuals experience neurological symptoms (e.g., paralysis, blindness, seizures) that cannot be explained by a neurological disease or other medical condition.
Illness Anxiety Disorder (previously Hypochondriasis): A disorder characterized by excessive worry about having or developing a serious illness, despite having no or minimal physical symptoms.
Factitious Disorder: A condition where individuals intentionally feign or induce physical or psychological symptoms to assume the sick role.
Malingering: The deliberate fabrication or exaggeration of physical or psychological symptoms for external gain (e.g., financial compensation, avoiding work).
Psychogenic: Originating from psychological or emotional factors rather than physical causes.
Psychosomatic: The interplay between psychological and physical factors in the development and manifestation of illness.
Medically Unexplained Symptoms (MUS): Physical symptoms that cannot be fully explained by a known medical condition after appropriate investigation.
Cognitive-Behavioral Therapy (CBT): A type of psychotherapy that focuses on identifying and changing unhelpful thoughts and behaviors to improve emotional and physical well-being.
Mind-Body Connection: The understanding that mental and emotional states can influence physical health and vice versa.
Stress: The body’s response to demands or pressures, which can contribute to the development or exacerbation of physical symptoms.
References
References
- Psychiatry, Fourth Edition- Oxford Medical Publications – SRG- by Geddes, Jonathan Price, Rebecca McKnight / Ch 32.
- A Short Textbook of PSYCHIATRY 7th edition by Niraj Ahuja / Ch 8.
- Homeopathy in treatment of Psychological Disorders by Shilpa Harwani / Ch 9.
- The prevalence and its correlates of somatization disorder at a quaternary mental health centre – PubMed (2019).
- Diagnostic and Statistical Manual of Mental Diorders (DSM-5), Fifth Edition, published by the American Psychiatric Association in 2013.
- Kaplan & Sadock’s Synopsis of Psychiatry – Benjamin J. Sadock, Virginia A. Sadock, Pedro Ruiz. This comprehensive textbook covers various psychiatric disorders, including somatoform disorders.
Also Search As
Also search as
Online search engines:
Use specific keywords:
- "homeopathy Somatoform disorder"
- "homeopathic treatment for Somatoform disorder"
- "homeopathic remedies for Somatoform disorder"
- "case studies homeopathy Somatoform disorder"
Use advanced search operators:
- Add "filetype:pdf" to find articles in PDF format
- Use quotation marks to search for exact phrases (e.g., "Somatic Symptom Disorder")
Search on specific homeopathic websites or databases:
- National Center for Homeopathy (NCH)
- Homeopathy Research Institute (HRI)
- Homeobook
Academic databases:
- Search databases like PubMed, Google Scholar, or ScienceDirect using relevant keywords.
- Filter results to include articles related to homeopathy.
Homeopathic journals:
- Browse through reputable homeopathic journals like:
- The American Journal of Homeopathic Medicine
- The European Journal of Integrative Medicine
- Homeopathy
- The Journal of the American Institute of Homeopathy
Social media and online forums:
- Join homeopathic groups and forums on platforms like Facebook and Reddit.
- Ask questions and seek recommendations from experienced homeopaths and individuals with knowledge of Somatoform Disorder.
Consult a homeopathic practitioner:
- Reach out to a qualified homeopath and inquire about relevant articles or research studies.
Frequently Asked Questions (FAQ)
What is Somatoform Disorder?
Definition
Somatoform disorder is a syndrome of prolonged physical symptoms in the absence of an identifiable organic cause with associated functional impairment in the context of an identifiable stressor.
What are Somatoform symptoms?
- Frequent headaches
- Back pain
- Abdominal cramping
- Pelvic pain
- Pain in the joints, legs and arms, and chest
- Abdominal pain
Can Somatic Symptom Disorder be cured?
While there is no cure, with appropriate treatment and management, individuals with Somatic Symptom Disorder can experience significant improvement in their symptoms and quality of life.
How is Somatic Symptom Disorder diagnosed?
Diagnosis
A diagnosis is typically made by a mental health professional after a thorough evaluation, including a physical examination to rule out any underlying medical conditions and a psychological assessment to identify excessive thoughts, feelings, and behaviors related to the symptoms.
What is the main cause Somatoform Disorder?
- Problem with the nerve impulses
- Herediatry
What are the treatment options for Somatic Symptom Disorder?
Treatment often involves a combination of psychotherapy (such as cognitive-behavioral therapy), medication (to address any co-occurring anxiety or depression), and lifestyle modifications (such as stress reduction techniques and exercise).
How does homeopathy treat Somatic Symptom Disorder?
Homeopathy aims to treat the whole person, considering their unique physical, mental, and emotional symptoms.Homeopathic remedies are selected based on the individual’s specific symptom picture and constitutional type.
Can homeopathy help with Somatoform Disorder (Somatic Symptom Disorder)?
Yes, homeopathy can be a supportive approach for individuals with Somatic Symptom Disorder by addressing the underlying emotional and mental states that contribute to physical symptoms.
Homeopathic Medicines used by Homeopathic Doctors in treatment of Somatoform Disorder?
Homoeopathic medicines for somatoform disorder
- Ignatia
- Asafoetida
- Moschus
- Tarentula
- Platinum
- Valereana
- Nux moschata
