Which adjective applies specifically to factitious disorders but not somatic symptom disorders

Somatic symptom and related disorders is the name for a group of conditions in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms can’t be traced to a specific physical cause. In people who have a somatic symptom and related disorders, medical test results are either normal or don’t explain the person’s symptoms.

People who have this disorder may have several medical evaluations and tests to be sure that they don’t have another illness. They often become very worried about their health because they don’t know what’s causing their health problems. Their symptoms are similar to the symptoms of other illnesses and may last for several years. People who have a somatoform disorder are not faking their symptoms. The pain that they feel is real.

There are several types of somatic symptom and related disorders.

Somatization disorder usually involves pain and severe neurological symptoms (such as headache, fatigue). Other symptoms include:

  • Digestive symptoms (such as nausea, vomiting, abdominal pain, constipation, and diarrhea).
  • Sexual symptoms (such as pain during sexual activity, loss of sexual desire, and extremely painful periods in women).

Hypochondriasis occurs when a person believes that normal body functions (such as a grumbling stomach) or minor symptoms (such as a common headache) are symptoms of a very serious disorder. To a person who has hypochondriasis, a grumbling stomach may mean stomach cancer. A headache may mean a brain tumor.

Body dysmorphic disorder occurs when a person becomes obsessed with a flaw in his or her physical appearance. The flaw is either a minor flaw or a flaw that doesn’t exist. He or she constantly worries about the perceived flaw, which can be any part of the body. Common concerns for people who have body dysmorphic disorder include:

  • wrinkles
  • hair loss
  • weight gain
  • size and shape of feature like the eyes, nose, and breasts

Conversion disorder is when physical symptoms that are similar to a neurological disorder develop even though no neurological disorder is actually present. Common symptoms include:

  • paralysis of an arm or leg
  • vision loss
  • hearing loss
  • seizure

Stress may make the symptoms worse.

No one knows exactly why symptoms of somatic symptom and related disorders appear. In some cases, there may be a problem with the nerve impulses that send signals of pain, pressure, and other unpleasant sensations to the brain. We do know that the pain and problems caused by somatic symptom and related disorders are real. They are not imagined.

Like many medical problems, somatic symptom and related disorders often run in families. They also tend to come and go over time.

Somatic symptom and related disorders can be difficult to diagnose. Your doctor will do a physical exam and possibly order tests. If tests show that you aren’t sick, your doctor may refer you to a mental health provider.

There is no known way to prevent somatic symptom and related disorders.

Although there is no known cure for somatoform disorders, they can be managed. Treatment focuses on helping the person who has the disorder to live as much of a normal life as possible. Even with treatment, he or she may still have some pain or other symptoms. Fortunately, a somatoform disorder will not shorten a person’s life.

Your doctor may be able to prescribe medicine for some of your symptoms. In many cases you will not need medicine.

Living with somatic symptom and related disorders can be hard. You may feel as though no one believes that you are really sick. You may not understand why this is happening to you. You may become frustrated with your body. Work with you doctor to manage your symptoms.

Seeing your doctor for regular checkups is the most important part of your treatment. Your doctor will tell you how often he or she needs to see you. You may feel frustrated if your symptoms continue but remember that somatoform disorders can be very difficult to treat. Your doctor will do his or her best to help you maintain your health.

Questions to ask your doctor

  • If I have a somatic symptom and related disorder, are my symptoms all in my head?
  • What is the likely cause of my disorder?
  • What is the best treatment option? Do I need therapy? Medicine?
  • Will lifestyle changes, such as learning how to manage stress, help relieve my symptoms?
  • How often do I need to visit for check-ups?

Resources

What are somatic symptom disorders?

Somatic symptom disorder is characterized by an extreme focus on physical symptoms — such as pain or fatigue — that causes major emotional distress and problems functioning. You may or may not have another diagnosed medical condition associated with these symptoms, but your reaction to the symptoms is not normal.

How is factitious disorder different from somatic symptom disorder?

Somatoform and factitious disorders both occur in cases where psychological disorders are related to the experience or expression of physical symptoms. The important difference between them is that in somatoform disorders the physical symptoms are real, whereas in factitious disorders they are not.

Is factitious disorder a somatic disorder?

Factitious disorder is classified under the Somatic Symptom and Related Disorders section of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)[1]. Other diagnoses under this section include somatic symptom disorder, conversion disorder, and illness anxiety disorder.

What is the difference between somatoform and factitious malingering disorders?

1. In the absence of overwhelming affirmative evidence of intentional medical deception (eg, caught on video, evidence from a room search), diagnose a somatoform disorder. 2. If there is traditional forensic evidence of overt medical deception, diagnose malingering or factitious disorder.