Somatoform Disorder

What is somatoform disorder?

Somatoform disorder is a mental illness that is the cause for bodily symptoms, which can include different types of pain. It is also called somatic symptom disorder (SSD) or somatization disorder.

There may or may not be any physical evidence that traces to a medical cause or diagnosis, but somatoform disorder causes disproportionate and excessive amounts of stress.

Many body systems or organs can be affected, and the symptoms include:

  • Gastrointestinal issues
  • General pain
  • Sexual problems
  • Neurologic issues

Those diagnosed with SSD are typically those with anxiety disorders or are those who have a previous mental illness.

It is important to know that patients who have SSD are not pretending like they have symptoms. They are experiencing real problems and pain, but physicians typically cannot locate a physical explanation. The distress level of the symptoms significantly affects their ability to function on daily basis. Before diagnosing a patient with SSD, many tests need to be performed to eliminate other potential causes.

Patients who have been diagnosed with SSD will likely experience a lot of frustration and stress. Having no physical explanation can cause patients to be unsatisfied because their distress levels are usually very high. This added level of stress could often cause patients to worry even more about their health, which can turn into a persistent cycle of worry for years. It can be highly frustrating when physicians cannot locate any symptoms. Symptoms are usually made much worse with stress.

The term “˜functional’ refers to SSD cases in which the doctor cannot find any physical symptoms. Functional symptoms refer to a function within the body that is not functioning correctly, but the cause is unknown. Medically unexplained symptoms also refer to somatization, but this can be dangerous as somatization refers to a specific set of symptoms.

Various somatoform disorders

Somatisation includes an extreme form, which are called somatoform disorders. While the external symptoms can be severe and more long-term, there is not a known disease that would cause these symptoms.

Somatoform disorders are:

  • Somatisation disorder
  • Hypochondriasis
  • Body dysmorphic disorder
  • Conversion disorder
  • Pain disorder

These are technically mental health disorders according to classification, due to the perceived mental influence. They are not caused by substance abuse, other mental health disorders, or depression.

SSDs have recently been renamed and are all now known as various types of somatic symptom disorders. Physicians used to diagnose their patients depending on multiple repeating symptoms, but have switched to focusing on the level of well-being that is affected by the symptoms. Those with cancer or arthritis can still, unfortunately, be diagnosed with somatic symptom disorder.


The fear that minor symptoms are caused by a severe disorder is hypochondriasis. An example of this would be the fear that a headache was brought on due to a brain tumor, or that a rash could cause skin cancer. This includes the thought that usual bodily functions like stomach rumbling were caused by a severe disease. The key factor in this diagnosis is fear.

Hypochondriasis does resemble somatization disorder. Those with hypochondriasis only fear that a disease that is caused by more serious causes, but those with somatization disorder believe there is a grave underlying factor. Doctors cannot typically influence patient’s beliefs because patients with hypochondriasis typically fear that the physician has just not located the disease yet.

Body dysmorphic disorder

This is a disorder in which an individual is constantly concerned or worried about their appearance. Someone who has body dysmorphic disorder will often focus on physical defects that other people usually cannot even see, or the defect may be real but the high concern is disproportionate to the defect.

For instance, someone may perceive their nose to be unusually shaped or a skin blemish is larger than it really is. The blemish or shape of the nose would usually go unnoticed by other people, but the person with body dysmorphic disorder can become excessively concerned with the defect. They may become focused on looking at themselves in the mirror to monitor the defect. Makeup is often used to hide the defect, and the idea of having the defect is highly troubling for individuals with this disorder. Some people go as far as to have a cosmetic surgeon alter the imagined or minor defect.

Conversion disorder

When an individual has symptoms that point to a serious nerve or brain disease (neurological disease) this is called conversion disorder. These disorders can include:

  • Deafness
  • Weakness, numbness, or paralysis in the arms or legs
  • Complete loss of eyesight (intense impairment of sight)

Stressful situations usually cause these symptoms to quickly develop. Mental stress is directly linked to physical manifestation of stress in the form of these disorders.

This disorder usually occurs within age 18-30. While symptoms typically only last a few weeks for most individuals, they can occur for long periods of time for other people. Many cases only have one episode with no need for further treatment. Other cases of conversion disorder have just one episode and do not require treatment after the symptoms are absent.

Pain disorder

This is a different type of disorder where there is obstinate pain. The pain is typically very stubborn and does not go away easily. Pain disorders do not typically have a connection to a physical cause.

Symptoms somatoform disorder

The physical symptoms that occur with SSD are usually intense.

The following symptoms can occur with Somatoform disorder:

  • Weakness or fatigue
  • Shortness of breath
  • Pain

The symptoms can range in severity from mild to very severe. More than one symptom can be present at a time, and often change from one symptom to another. These signs can come and go, and medical conditions can cause symptoms. There may not be a clear reason for the symptoms.

Reactions people have toward the painful physical sensations are the symptoms of SSD. There must be at least a 6-month period of these reactions occurring to technically have SSD.

Those who have SSD will likely:

  • Worry that symptoms are linked to serious diseases
  • Experience major anxiety about their symptoms
  • Worry that the doctor will not believe their symptoms or thinks the doctor has not properly treated the issue
  • Disbelief of results done for multiple medical procedures and tests
  • Difficulty functioning due to feelings, behaviors, and thoughts
  • Expend a lot of energy and time worrying about health concerns

Tests and exams

An entire physical exam will be completed to determine physical causes. Various tests will be conducted, and which tests are done will directly depend on the symptoms. A mental health professional can do further testing if needed.

Somatoform disorder causes

Somatoform disorder typically shows signs prior to age 30. Women typically encounter the disorder more than men. It is unfortunately unknown as to the reasons behind the development of this condition.

The following factors may have an impact:

  • Personal history or family upbringing
  • Genetics
  • Negative personality or outlook
  • Extreme sensitivity – emotionally and physically – towards pain and related sensations

Those with a history of sexual or physical abuse can be more likely to develop this disorder. SSD is comparable to an anxiety disorder; people grow worried about developing an illness or getting sick in general constantly. There are little to no actual symptoms, but people are wholly expecting to get very sick sometime in the future.

Somatoform disorder treatment

It is important to understand when a professional needs to be called. People with somatic symptom disorder should be evaluated by a mental health physician as soon as possible.

It can be simpler to deal with unnecessary tests that may be requested early before the disorder becomes too difficult to manage. Those with this disorder may experience poor productivity while working or have relationship difficulty, which are other reasons to evaluate this disorder as soon as possible. Unfortunately, patients may purposefully avoid treatment or prolong it, which is counterproductive.

Psychotherapy is a diagnosis that tends to resolve slowly. The patient has likely been living with the disorder already for years prior to beginning treatment. While it can be tough to break habits or stubborn patterns of behavior, support and persistence can make progress a reality for many patients. Some physicians believe that medications can be of some aid.

Improving daily functioning for patients is the goal, instead of simply managing the symptoms. Reducing the stress level for patients is highly important for improving the state of the patient. Friends and family of the patient may benefit from counseling. Symptoms that are linked to SSD may be relieved by cognitive behavioral therapy.

The therapy aims to correct:

  • Beliefs that are unrealistic
  • Thoughts that may be distorted
  • Behavior that urges health anxiety

People who have SSD may genuinely believe that there is a physical cause for their symptoms even though there is no medical evidence. If the patient is experiencing a medical condition that is the underlying cause of the symptoms, the amount of pain or distress is excessive. Patients typically dismiss the possibility of psychiatric factors affecting their symptoms. It is essential to have a good patient-doctor relationship to improve SSD. Health care providers who have experience working with patients who have SSD typically know which treatments or tests are unnecessary.

Somatoform disorder prevention

Unfortunately, there are not any prevention methods for somatization disorder.

In order to reduce the chances of developing this disorder, the following steps can help:

  • Lower the amount of daily stress you are experiencing
  • Maintain a positive and open relationship with your healthcare provider or general physician
  • Maintain awareness of your overall emotional and psychological health

Psychological intervention may be helpful for those who are experiencing somatization. It would be useful for those with the disorder to learn new ways of handling their stress. New ways of coping may also help to lower the intensity of symptoms they may be experiencing.

In order to avoid excessive testing, an accurate diagnosis is important. This can be a challenge for the physician and the patient because symptoms have the potential of being caused by other medical problems.

Somatoform disorder complications

Patients who genuinely have rare medical conditions that are not widely understood can be misdiagnosed with what is thought to be somatoform disorder. This is occurring more and more since physicians do not have much time for each patient. While somatoform disorder is likely the easy diagnosis, it may not always be correct.

There are also risks of desensitizing the patient’s family and friends if there are too many “˜false alarms’. It can be time-consuming, expensive, and stressful to deal with testing and hospital or doctor visits due to symptoms that can flare up. These trips to the physician’s office often do not typically produce definitive results, but they decrease the likelihood that people will take the patient seriously in the future.

However, it is important that symptoms be taken seriously because there is the chance that it could always be caused by an urgent medical condition.

Last Reviewed:
September 12, 2017
Last Updated:
September 12, 2017
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