Causes and Diagnosis of Somatoform Disorder - Essay Example

Somatoform Disorder Name Institution Introduction Somatoform disorder is a group of mental disorders that are placed in a common category, basing on their external symptoms. According to Dimsdale (2009), the disorders are characterized by physical complaints that seem to be medical in origin and cannot be described in terms of physical disease, the cause of substance abuse or by another psychological disorder. Somatoform is a psychological disorder that is usually characterized by physical symptoms which include physical illness or injury. The disorders are always hard to be explained fully by a general medical condition, direct impact of a substance or to be linked with another mental disorder such as panic disorder. Patients with somatoform disorder may worried about their health because doctors find it hard to establish the cause for the individual’s health problems (Surhone & Timpledon 2010). The history of somatoform disorder According to Trimble (2004), the prehistoric Egyptians attributed somatoform disorders to a wandering uterus. Rene Descartes’ seventeenth century paradigm of separation among the psyche and soma protected the advancement of reductionist medical model with dualist outlook that affect the management of conversion symptoms. In the eighteenth century, disease theories such as humoral theories and master-organ theories emerged (Shives, 2007). In the nineteenth century, reflex theory stated that all organs can influence all other organs irrespective of the mind and the will. According to Videbeck (2010), Charcot conceptualized hysteria as an inborn Central Nervous System disease that is caused by functional lesions in nervous system and cannot be localized. Towards the end of nineteenth century, the concept of dissociation was known as psychological automatisms and emphasized the coexistence of different mental systems that would be incorporated into the perception of an identity of a person (Dimsdale, 2009). The concept of dissociation was initially influenced by Freud’s psychoanalysis model. Early neurobiological models also suggested that conversion reactions were associated with conflicts, including dangerous conflicts that were being associated with fear. Behavioral models explained conversion symptoms as communication diseases or a social construct with disagreement or lack of understanding among patients and doctors. Freud coined the term “conversion” to imply the substitution of somatic symptoms for reserved emotions. Historically, conversion terms such as ‘hysteria’ and ‘conversion hysteria’ were interchangeably employed to explain a condition characterized by one somatoform symptom, that is, a pseudo-neurologic system (Salloum & Mezzich, 2009). According to Videbeck (2010), it is important to know that the current classification of psychological disorders reflects the present historical changes in the medicine and psychiatry practice. When psychiatry initially became a separate branch of medicine towards the end of nineteenth century, the term hysteria is used to describe mental disorders that are characterized by altered states of consciousness such as sleepwalking or physical symptoms such as leg with no neurologic cause that could not be explained fully by a medical disease. The term dissociation was applied in psychological mechanism that permits the mind to help in reducing painful feelings, memories or ideas that are lost to conscious recall. Sigmund Freud and other psychoanalysts believed hysterical symptoms results from dissociative thoughts or memories that re-emerged through bodily functions or trace states. Prior to categorization, all psychological disorders that were taken to be forms of hysteria were categorized together on the basis of this theory. Since 1980, somatoform disorders and dissociative disorders have been placed in different categories basing on their chief symptoms. Maj and Akiskal (2005) point out that somatoform disorders are characterized by turbulences of the physical conditions of the patient or a person’s capability to move the limbs or to walk, while the dissociative disorders are characterized by disturbances of the patient’s sense of identity or memory. As a group, somatoform disorders are hard to identify and treat because patients tend to have long histories of medical or surgical treatment with a number of different doctors. In addition, the physical symptoms are not always under the conscious control of the patient. Patients always find it hard to intentionally try to confuse the doctor or to complicate the process of diagnosis. Somatoform disorders, however, are important problem in the health care system because patients with these turbulences normally overuse medical services and resources (Maj & Akiskal, 2005). Conceptualization of somatoform disorder To keep with a broader definition of somatoform disorder, a wider conceptualization is required so that emerging questions can be addressed. More emphasis needs to be placed on biological research regarding somatoform disorders. There are a lot of evidences that proofs biological processes as contributors to somatoform disorders. For instance, patients with many somatic symptoms might also have immunological abnormalities that vary from those of that are depressive, implying that depression and somatoform disorders are separate syndromes (Perkin & Swift, 2007). There are also early outcomes from the use of Functional Brain Imaging (FBI) to analyze cerebral and peripheral processes that contributes to the growth of physical symptoms. These findings imply somatoform symptoms are not only related to cognitive and behavioral features, but also to psycho-physiological and psychobiological changes. Somatoform disorders are applicable to all medical disciplines and in most cases they can be seen by non-psychiatric physicians than by psychiatrists. It is therefore important to place them in a completely new group, for example, they can be placed in section U in ICD-10 instead of placing them in F-category of psychiatric disorders (Barlow & Durand, 2008). According to First and Tasman (2009), somatoform disorder is usually regarded as a problem that requires high levels of understanding on the part of doctors, or a health care system’s problem. It is known to many people that medical system is usually biased in its focus on diseases. Consequently, communication among doctors and patients is always hard especially when patients lack clear organic pathology. The control of somatoform symptoms is usually characterized by obvious invalidations of patients’ complaints and therefore the understanding of somatoform disorders should include the interaction of the patients with health care system that is biased somatically and the definition of somatoform disorder should incorporate culture. McKay (2009) notes that the functions of somatoform disorder need to be included in the whole context of medicine. Somatoform disorders are always portrayed as a marginal, abandoned wasteland among the walled fortresses of medicine and psychiatry. It can be argued that the prevailing ‘disease-focused’ approach to illness performed by modern western medicine can only exist if the huge numbers of patients whose somatic symptoms cannot be described by the disease. Psychological disorders are not broadly recognized but the professional classifications of psychological illnesses are subjected to not less than socio-cultural effects. The symptoms or experiences of the illnesses are usually very intense. This is because psychological disorders are complicated in etiology and dimensional in nature, for instance common sadness versus depression, and existential anguish versus universal anxiety disorder. The absence of biological markers that prevents etiological diagnosis is another identified reason why psychological disorders are complicated in etiology and dimensional in nature. The facts about diagnostic groups in psychiatry produces tensions with practical requirements in clinical practice and professional training that aims at creating the right diagnosis (Shives, 2007). It is nevertheless, important to remember that physical diseases that are complicated in manifestations and etiology such as autoimmune diseases or dimensional in nature such as hypertension do have similar amount of nososlogical and diagnostic controversies as it is the case with psychological disorders (Trimble, 2004). This therefore, implies that categorization and definition of psychological disorders might be vulnerable to nonscientific effects and might serve diverse purposes for various parties. It is important to know that scientific categories usually change and can be affected by politics, culture and economics (Weiten & Lloyd, 2008). Somatoform disorders are not the out comes of conscious malingering, fabricating or overstating symptoms for secondary reasons, or factious disorders such as pretending. It is therefore important for a person to be able to differentiate between somatoform disorder and specific diagnosis of a somatization disorder. The change of somatoform disorder in DSM-V Somatoform disorder in DSM-V can change and the changes can happen in various ways. More important, at least in theory, are the cross-cutting, structural and general grouping matters. This is where the impressive changes of the whole diagnostic approach normally take place. The changes can turn out to be pretty modest. In the axis system, most disorders are denoted as Axis I, personality disorders are denoted as Axis II and other medical illnesses are denoted as Axis III. These types of groupings need to be abolished and a single Axis to be used. By doing this, somatoform disorder will change since it will have some practical effect on it (Shaw & DeMaso, 2010). Though DSM-V has not gone very far, its new dimensional evaluations have been proposed, which are planned to complement the diagnoses. This will enable some of them to be cross cutting, that is, they will not be tied to one specific diagnosis thus bringing about change on somatoform disorder. Weiner & Craighead (2010) argue that the concept of psychological disorder is being redefined. In DSM-V psychological disorder can be defined as a behavioral or psychological condition or pattern that occurs in a person. The main change therefore is that DSM-V concentrates more on psychological dysfunction, different from DSM-IV that concentrates on behavioral, psychological or biological dysfunction. The rationale that the work group is using to support its decision The work groups are basing their decisions on the white papers. In a DSM-V research planning conference that was held in 1999, the research priorities were set by different stakeholders. In this research the work groups gave out white papers that are required to inform and direct DSM-V on research. The outcome of the work and recommendations were recorded in an APA monograph and in a peer-reviewed literature. Six work groups were available, each concentrating on a wide topic such as nomenclature, neuroscience and genetics, developmental matters and diagnosis, relational disorders and personality, psychological disorders and disability, and cross-cultural matters. By 2004 some additional white papers were available. The white papers focused on gender issues, diagnostic matters in the geriatric population, and psychological disorders in babies and young children. The white papers were accompanied by a series of conferences to produce recommendations that associates with specific disorders and matters. Only twenty five invited researchers were invited to attend the conference (Porcelli & Sonino 2007). Conclusion From our discussion it is clear that somatoform disorder is a mental abnormality that cannot be easily described in terms of physical disease. Doctors always find it hard to identify the cause of health problems since somatoform disorders are as a result of mental factors. The conceptualization of somatoform disorder is quite broad. Somatoform disorder is assumed to be the problem of a patient and its control is marked by an obvious invalidation of complaints of the patient. Its understanding also incorporates the interaction of the patients with the health care system. Somatoform disorder can be broadly defined so that it incorporates culture. In our discussion, it is also clear that Somatoform disorder can change in DSM-V. References Surhone M. L. & Timpledon T. M. (2010). Somatoform Disorder. New York: VDM Verlag Dr. Mueller AG & Co. Kg. Trimble R. M. (2004). 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