What are somatoform disorders, and what are the types of this disorder?

QUESTION

Case Study, Mohr

CHAPTER 24, Somatoform, Dissociative, and Sexual Disorders

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In completing the case study, students will be addressing the following learning objectives:

Describe possible etiologies of somatoform disorders.

Explain the features of various somatoform disorders.

Identify the most common interdisciplinary goals and treatments for clients with somatoform disorders.

1. Roger is a 60-year-old, twice-divorced, Hispanic man who is retired. His only support system is two adult sons with whom he has a distant relationship. Roger has medical insurance from his retirement and constantly complains that he has some medical problem. He “doctor shops” by seeing different doctors for his various complaints. Roger is always asking the doctors if he needs surgery. In the past 5 years, he has undergone an exploratory laparotomy for complaints of abdominal pain, three colonoscopies for complaints of alternate diarrhea and constipation, and numerous diagnostic tests for his many physical complaints. All tests and procedures have negative findings for any physical basis. Roger remains convinced that he has multiple problems that the doctors are unable to diagnose.

(Learning Objectives: 1, 3)

a. What are somatoform disorders, and what are the types of this disorder?

b. Based on the information given in the case study, what contributing factors do you believe Roger has? What other factors, not included, could contribute to somatoform disorders? Name the appropriate disciplines involved in the treatment of Roger and the interdisciplinary goals and interventions in treating his somatoform disorder.

ANSWER

Understanding Somatoform Disorders and Treatment Approaches: A Case Study Analysis

Introduction

This essay explores the case study of Roger, a 60-year-old retired Hispanic man who exhibits symptoms indicative of somatoform disorders. We will delve into the definition and types of somatoform disorders, analyze the contributing factors relevant to Roger’s condition, and discuss the interdisciplinary approach to his treatment. By addressing these key aspects, we aim to enhance our understanding of somatoform disorders and the holistic interventions required for effective management.

Somatoform Disorders

Types and Features Somatoform disorders encompass a group of psychological disorders characterized by physical symptoms lacking any identifiable medical basis. These disorders are typically associated with significant distress and impairment in functioning. The types of somatoform disorders include:

Conversion Disorder: Conversion disorder manifests as neurological symptoms such as paralysis, blindness, or seizures, without any physiological cause (Peeling, 2023). The symptoms often resemble those of a neurological disorder, but medical evaluations fail to reveal any corresponding abnormalities.

Somatization Disorder: Somatization disorder involves a chronic history of multiple physical complaints across various organ systems. These complaints persist for an extended period and are not explained by any specific medical condition.

Hypochondriasis (Illness Anxiety Disorder): Hypochondriasis entails excessive worry and fear of having a serious medical condition, despite having minimal or no medical evidence to support such concerns. Individuals with hypochondriasis often seek frequent medical consultations and examinations.

Contributing Factors in Roger’s Case

Based on the provided information, several contributing factors to Roger’s somatoform disorder can be identified. These include:

Limited Support System: Roger’s distant relationship with his adult sons suggests a lack of emotional support. Social isolation and limited connections can contribute to increased anxiety and the manifestation of somatic symptoms.

Retirement and Loss of Identity: Retirement can lead to a loss of purpose and identity, resulting in psychological distress. Roger’s repeated medical complaints may reflect an attempt to regain a sense of significance and attention in his life.

Cultural Factors: Roger’s Hispanic background may play a role in shaping his attitudes towards seeking medical help. Cultural beliefs and expectations around illness and healthcare utilization can influence the manifestation of somatic symptoms.

Interdisciplinary Approach to Treatment

Effective treatment of somatoform disorders requires an interdisciplinary approach involving various disciplines and professionals. In Roger’s case, the following disciplines can be involved:

Psychiatry/Psychology: Mental health professionals can conduct thorough assessments, provide psychoeducation, and offer individual psychotherapy sessions (England, 2015). Cognitive-behavioral therapy (CBT) and psychodynamic therapy may be employed to address underlying psychological factors contributing to somatic symptoms.

Primary Care/Internal Medicine: Primary care physicians play a vital role in coordinating the care of individuals with somatoform disorders. They can establish a therapeutic alliance, manage any comorbid medical conditions, and provide ongoing medical reassurance.

Social Work: Social workers can assess Roger’s social support system, connect him with appropriate community resources, and assist in addressing any social or environmental stressors that may contribute to his symptoms.

Interdisciplinary Goals and Interventions

The interdisciplinary goals for treating Roger’s somatoform disorder may include:

Building Trust and Therapeutic Alliance: Establishing a trusting relationship with Roger is crucial to address his psychological needs and concerns.

Psychoeducation: Educating Roger about somatoform disorders can help him understand the mind-body connection and reduce anxiety surrounding his symptoms.

Cognitive-Behavioral Therapy (CBT): CBT techniques can be employed to challenge maladaptive thoughts, promote coping skills, and encourage healthier ways of managing stress and emotions (Sarkhel et al., 2020).

Multidimensional Assessment: Conducting a comprehensive assessment to identify and address biological, psychological, and social factors contributing to Roger’s symptoms.

Conclusion

Roger’s case exemplifies the complexity of somatoform disorders and highlights the need for an interdisciplinary approach to treatment. By understanding the types and features of somatoform disorders, identifying contributing factors, and involving various disciplines, healthcare professionals can provide comprehensive care that addresses both the psychological and physical aspects of the disorder. Through collaborative efforts, individuals like Roger can receive the necessary support and interventions to alleviate their symptoms and improve their overall well-being.

References

England, M. J. (2015, September 18). Introduction. Psychosocial Interventions for Mental and Substance Use Disorders – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK321284/ 

Peeling, J. L. (2023, May 8). Conversion Disorder. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK551567/ 

Sarkhel, S., Sundar, S., & Arora, M. (2020). Clinical Practice Guidelines for Psychoeducation in Psychiatric Disorders General Principles of Psychoeducation. Indian Journal of Psychiatry, 62(8), 319. https://doi.org/10.4103/psychiatry.indianjpsychiatry_780_19 

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