SOMATOFORM DISORDERS DIAGNOSIS |
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Accurate diagnosis of somatoform
disorders is important to prevent unnecessary surgery, laboratory
tests, or other treatments or procedures. Because somatoform
disorders are associated with physical symptoms, patients are often
diagnosed by primary care physicians as well as by psychiatrists. In
many cases the diagnosis is made in a general medical clinic.
Children and adolescents with somatoform disorders are most likely
to be diagnosed by pediatricians. Diagnosis of somatoform disorders
requires a thorough physical workup to exclude medical and
neurological conditions, or to assess their severity in patients
with pain disorder. A detailed examination is especially necessary
when conversion disorder is a possible diagnosis, because some
neurological conditions--including multiple sclerosis and myasthenia
gravis--have on occasion been misdiagnosed as conversion disorder.
Some patients who receive a diagnosis of somatoform disorder
ultimately go on to develop neurologic disorders.
In addition to ruling out medical causes for the patient's symptoms,
a doctor who is evaluating a patient for a somatization disorder
will consider the possibility of other psychiatric diagnoses or of
overlapping psychiatric disorders. Somatoform disorders often
coexist with personality disorders because of the chicken-and-egg
relationship between physical illness and certain types of character
structure or personality traits. At one time, the influence of
Freud's theory of hysteria led doctors to assume that the patient's
hidden emotional needs "cause" the illness. But in many instances,
the patient's personality may have changed over time due to the
stresses of adjusting to a chronic disease. This gradual
transformation is particularly likely in patients with pain
disorder. Patients with somatization disorder often develop panic
attacks or agoraphobia together with their physical symptoms. In
addition to anxiety or personality disorders, the doctor will
usually consider major depression as a possible diagnosis when
evaluating a patient with symptoms of a somatoform disorder. Pain
disorders may be associated with depression, and body dismorphic
disorder may be associated with obsessive-compulsive disease. |
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| SOMATOFORM DISORDERS RELATED ITEMS |
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