Somatization

Somatization

Definition:

Somatization disorder is along –term (chronic) condition in which a person has physical symptoms that involve more than one part of the body ,but no physical cause can be found.

The pain and other symptoms people with this disorder feel are real, and are not created or faked on purpose (malingering)

Causes:

The disorder usually begins before age 30 and occur more often in women than in men .the disorder is more common in people with IBS and chronic pain.

Symptoms:

 Many Physical complaints that last for years .  Most often the complaints involve chronic pain and problems with the digestive system  , CNS , and reproductive system.

The symptoms  often interfere with work , relationships, and lead to many visits to different health care providers.

Symptoms includes:

Abdominal pain

Back pain 

Chest pain 

Diarrhea

Difficulty swallowing

Headache

Nausea and sometimes vomiting

Pain during intercourse

Pain during urination

Pain during menstruation

Palpitations

Paralysis or muscle weakness

Vision changes

Exams and Tests:

Physical examination and diagnostic tests are perform to identify physical causes, no physical  cause is found to explain the symptoms , somatization disorder may be diagnosed.

A psychological evaluation is performed to  identify related  disorders.

Treatment:

The goal of treatment is to help patients to control their symptoms.

Having supportive  relationship with a health care provider is the most important part of treatment.

You should have only one primary care provider, to avoid having too many tests and procedures.

Schedule regular appointments to review the symptoms and how you are coping.  The  health care provider should  explain any test results.

Psychotherapy can be helpful

Cognitive behavioral therapy (CBT) can help you deal with your pain.

If the condition associated with  depression or anxiety antidepressants can help.

Conversion disorders

(dissociative & also called functional  neurological symptoms disorders)

Definition:

Is a condition in which pt show psychological  stress in physical ways(loss or disturbance of normal motor or sensory function which initially appears to have a neurological or others physical cause.

Clinical features:

May appears suddenly after stressful event or trauma.  Sign& Symptoms that affect movement function may include:

Weakness or paralysis

Abnormal movement, such as tremors or difficulty walking

Loss of balance

Difficulty swallowing or lump in the throat

Seizures or convulsions

Sign& Symptoms that affect the senses may include:

Numbness or loss Of the touch sensation

Speech problems, such as inability to speak or slurred speech

Vision problems such as double vision or blindness

Hearing problems or deafness

Amnesia (memory loss)

Causes

The exact cause of conversion disorder is unknown

Nearly always triggered by a stressful event , and emotional conflict or another mental health disorder, such as depression.

Diagnosis

Usually be suspected due to the non-anatomical or clinically inconsistent nature of the signs

Risk factors

Recent significant stress or emotional trauma

Being female

Having a mental health condition, such as anxiety disorders , or certain personality disorders

Having a neurological disease that cause similar symptoms ,such as epilepsy

Having a family member with conversion disorders

Treatment:

Counseling( psychotherapy) , reassurance ,supportive, and family therapy

CBT

IPT

Prognosis

For acute symptoms, especially those with a clear precipitant, the prognosis is good, with expectation of complete resolution of symptoms (70-90%)

Poorer outcomes for longer-lasting and well-established symptoms

Thank you

&

Best wishes