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Somatoform symptom disorders
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Somatoform symptom disorders

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Contributors: Richard L. Barbano MD, PhD
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Synopsis

Somatoform disorders encompass several disorders all linked by the presence of symptoms suggesting a medical condition for which no explanatory diagnosis is found. Historically, this group has included somatization disorder (a repeating pattern of "medically unexplained symptoms" starting before age 30 and involving several organ systems), conversion disorder (mimicking a neurologic diagnosis, eg, a pseudoseizure), somatoform pain disorder (with or without an accompanying medical condition), hypochondriasis (a persistent preoccupation with having a serious medical condition despite adequate workup), and body dysmorphic disorder. They have in common that the symptoms are not intentionally produced (as opposed to factitious disorder or malingering). These disorders are common in medical practice.

Patients can present as new patients seeking diagnoses that other physicians "could not figure out," and it is not uncommon for these patients to seek consultations with multiple medical specialists. The patients may convey significant distress; explanation that an adequate evaluation has been performed is not always accepted and satisfying. There is a significant comorbidity with anxiety and affective disorders. When severe, hypochondriasis and body dysmorphic disorder can take on delusional qualities. These tend to be lifelong disorders with waxing and waning severity. A consistent, supportive doctor-patient relationship is essential for therapeutic effect.

Codes

ICD10CM:
F45.21 – Hypochondriasis
F45.9 – Somatoform disorder, unspecified

SNOMEDCT:
31297008 – Somatoform disorder

References

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Last Updated: 10/16/2017
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Somatoform symptom disorders
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Somatoform symptom disorders : Anxiety, Pain out of proportion to exam findings, Recurring episodes or relapses
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