Somatization Disorder - Research Paper Example

 Somatization Disorder Introduction Somatization disorder alternatively known as hysteria or Briquet’s syndrome is a condition, which is characterized by multiple and recurrent complains of pain, pseudo-neurological, sexual and gastrointestinal symptoms (APA, 2000). Upon diagnosis most of these symptoms lack a clear physiological cause. These symptoms characteristically begin before age 30 and may persist for a number of years, and this may result in significant treatment or treatment seeking behavior. In spite of the fact that there is no physical cause of these symptoms, the pain and symptoms are real to the patient and not faked or created. The ‘somatic’ symptoms that characterize the condition cause impairment, which impedes normal functioning and could cause significant distress. Epidemiology Hysteria is not common in the general populace. However, the condition occurs in 0.2% of males and 0.2% to 2% of females (Lichstein, 1986). Research has proven variation in occurrence, which is attributable to cultural differences. For example, the condition is significantly prevalent in Puerto Rico when compared to other regions (Glorisa et al. 2000). Approximately 10% to 20% percent of first-degree female relatives have the disorder, whereas; the male relatives exhibit heightened levels of sociopathy and alcoholism. Epidemiological studies also show that there is co-morbidity with other conditions of a psychological nature such as anxiety disorders, mood disorders and personality disorders such as dependent, narcissistic, borderline, avoidant, histrionic and antisocial personality disorders (Robert & Gold, 2008). Symptoms Patients with somatisation disorder display various physical complaints which may last for years. These complains often include chronic pain and problems in the reproductive, nervous and digestive systems. Stress has been found to worsen the problem and the symptoms often interfere with both relationships and work as patients seek medical attention (Lichstein, 1986). Diagnosis and other evaluations do not explain the symptoms or they may exceed expectations when compared to any medical illness of a similar nature that may be found. Symptom categories that may be experienced include: Neurological symptoms: seizures, weakness, numbness, paralysis, vision problems and problems with balance or coordination. Menstruation-related symptoms: painful menstruation and irregular periods. Sexual symptoms: intercourse pain, lack of interest and erectile dysfunction. Gastrointestinal symptoms: difficulty swallowing, bloating, diarrhoea, vomiting and nausea. Pain: chest pain, joint pain, stomach ache, back ache and headache (Lichstein, 1986). Risk factors, Incidence and Causes Somatization disorder starts prior to age 30 and is more prevalent among women than in men. The condition often affects people with chronic pain and irritable bowel syndrome. Somatisation disorder was in the past thought to relate to emotional stress, and the resultant pain was dismissed as a creation of the mind (Pribor et al. 1993). However, people with the condition seem to experience various symptoms and pain in a manner that elevates the pain level. The worry and pain create a hard to break cycle. It has also been noted that people with a history of abuse (physical or sexual) tend to experience the disorder when compared to those that have never experienced any abuse (Pribor et al. 1993). However, it should be noted that not all people with the condition have had a history of abuse. Research has also shown that the brain-body connection may be used to explain the condition and it may be linked to emotional well-being which affects how individuals perceive pain or any other symptoms. Diagnosis and Tests In order to determine the existence of the condition diagnostic tests and thorough physical examinations have to be conducted to determine the physical causes. The diagnostic tests carried out depend on the symptoms that the patient presents (APA, 2000). Thereafter, a psychological evaluation is conducted to determine whether there are any related disorders. If after these diagnostic tests there are no physical causes determined, then, the disorder may be determined to be somatisation disorder. Diagnosis often relies on the DSM-IV-TR criteria and according to the criteria the following indicators may point to the presence of the condition (APA, 2000). History of complaints starting before age 30 and occurring over several years. The presence of pain in four different sites of the body, and least one pseudo-neurological symptom, one sexual dysfunction and two gastrointestinal symptoms. Lack of a condition associated with the symptoms and the inability to explain the disorder in general medical condition terms or in relation to substance abuse or the symptoms are severe than expected. The complaints of pain are not feigned (APA, 2000). The observed symptoms should not necessarily occur simultaneously, but may occur over the course of the problem (APA, 2000). Treatment The major aim of treatment is to aid the patient in controlling symptoms. It is important to have one provider of primary care to prevent undergoing many procedures and tests under different practitioners. So far, cognitive behavioral therapy (CBT) has proven to be an effective treatment approach for a wide array of somatoform disorders (Kurt, 2007). Therefore, it is necessary to find a practitioner with experience in treating the condition with psychotherapy. In therapy the patient will learn how to: Stay active even when still under pain. Develop a means of coping with the symptom. Determine whatever seems to worsen the pain. If the condition is anxiety or depression-related then the use of antidepressants is recommendable to deal with the situation (Kurt, 2007). Theories Explaining the Origin of Somatization Disorder In spite of the fact that somatization disorder has been diagnosed and studied for a very long time, there is still uncertainty and debate regarding the condition’s pathophysiology. A large number of the pathophysiological explanations offered rely on the concept of an existent misconnection between the body and the mind. There are a number of widely held theories and these fit into three categories. The first advanced theory holds that the symptoms of the disorder are a representation of the body’s defense against psychologically-based stress (Pribor et al. 1993). According to this theory, the mind has a limited capacity of coping with stress and once this finite limit is reached the strain and stress manifests as physical pain-somatization disorder (Pribor et al. 1993). Exceeding the limit principally manifests as reproductive, nervous and digestive system disorders. In recent studies researchers have established a connection between the immune system and the brain and the digestive system. This perhaps explains why depression and the irritable bowel syndrome are linked to somatization disorder (APA, 2000). The second theory explains somatization disorder through hypersensitivity. According to this theory the disorder occurs due to heightened sensitivity to physical sensations. The theory postulates that some people have the ability to sense the slightest amount of discomfort and pain than most other people, and are thus vulnerable. The sensitivity allows people with condition to perceive pain within thresholds that average people may not be able to perceive. The origins of this hypersensitivity are, however, not well explained or known (Encyclopedia of Mental Disorders, 2013). The third theory holds that the condition is a result of an individual’s overemphasized fears and thoughts. The theory explains that the individuals with slight or minor pains may elevate or worsen the pain by negatively thinking about the pain (Encyclopedia of Mental Disorders, 2013). For example, a patient may think that a headache is caused by a tumor and therefore, worsening his/her state of pain and condition or symptoms. The patients often think that their condition may be of a rare or serious disease because the doctor has failed to find a physiological or physical cause, and this unconsciously aggravates their pain and negative feeling (Encyclopedia of Mental Disorders, 2013). References American Psychiatric Association (APA) (2000). Diagnostic and Statistical Manual of Mental Disorders, Forth Edition, Text Revision: DSM-IV-TR. Washington, DC: American Psychiatric Association. pp. 486–490. Encyclopedia of Mental Disorders (2013). Somatization Disorder, retrieved from http://www.minddisorders.com/Py-Z/Somatization-disorder.html Glorisa, C. Bird, H. Rubio-Stipec, M. Bravo, M. (2000). The epidemiology of mental disorders in the adult population of Puerto Rico. Revista Interamericana de Psicologia. 34 (1X): 29–46. Kurt, K. (2007). Efficacy of treatment for somatoform disorders: A review of randomized controlled trials. Psychosomatic Medicine 69 (9): 881–888. Lichstein P. R. (1986). Caring for the patient with multiple somatic complaints. Southern Medical Journal 79 (3): 310–314. Pribor, E. F., Yutzy, S. H., Dean, J. T., Wetzel, R. D. (1993). Briquet's Syndrome, dissociation and abuse. American Journal of Psychiatry, 150 (1), 1507-1511. Robert, F. B. & Gold, S. H (2008). Co-morbidity of personality disorders and somatization disorder: A meta-analytic review. Journal of Psychopathology and Behavioral Assessment 30 (2): 154–161. Read More