Understanding Somatoform Disorders: Causes, Symptoms & Support

What Are Somatic Symptom and Related Disorders?

Somatoform disorders (now classified in DSM-5 as Somatic Symptom Disorder, Illness Anxiety Disorder, Conversion Disorder, Factitious Disorder, etc.) involve distressing somatic symptoms with excessive thoughts, feelings, or behaviors related to them. The symptoms are not intentionally produced and cause genuine suffering.

Key Diagnoses

Etiology

• Biological: Genetic vulnerability, altered interoception, central sensitization.
• Psychological: Alexithymia, trauma, maladaptive coping, reinforcement of sick role.
• Social: Family modeling, cultural illness beliefs, healthcare system reinforcement.

Treatment

• CBT – cognitive restructuring, exposure, behavioral activation.
• Antidepressants (SSRIs/SNRIs) for comorbid anxiety/depression.
• Physical therapy (graded exercise) for conversion/movement disorders.
• Regular physician visits (scheduled, not symptom-contingent) to reduce help-seeking.
• Multidisciplinary team (PCP, psychiatrist, PT, OT).

Early intervention improves function and reduces healthcare overutilization.

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Disorder	Core Feature
Somatic Symptom Disorder	≥1 distressing somatic symptom + excessive thoughts/anxiety/behavior for ≥6 mo
Illness Anxiety Disorder	Preoccupation with having serious illness despite minimal/no symptoms
Conversion Disorder (Functional Neurological Symptom Disorder)	Neurologic symptoms (weakness, seizures, blindness) incompatible with known disease
Factitious Disorder	Intentional falsification of symptoms to assume sick role (no external reward)