Somatic

Symptom Illness
Devianne Jane E. Daiz
Learning Outcomes:

• Explain what is meant by “psychosomatic illness”.

• Describe somatic symptom illnesses and identify

their three central features.

• Discuss the characteristics and dynamics of specific

somatic symptom illnesses.
Learning Outcomes:

• Discuss the etiologic theories related to somatic

symptom illnesses.

• Apply the nursing process to the care of clients with

somatic symptom illnesses.
Definition of Terms

• Psychosomatic
- the connection between the mind (psyche) and
the body (soma) in states of health and illness.

• Somatization
- the transference of mental experiences and
states into bodily symptoms.
Somatic Symptom Illness

Three central features:

1. Physical complaints suggest major medical illness

but have no demonstrable organic basis.
2. Psychological factors and conflicts seem important
in initiating, exacerbating, and maintaining the
symptoms.
3. Symptoms or magnified health concerns are not
under the client’s conscious control.
Somatic Symptom Illnesses:

• Somatic symptom disorder

- characterized by one or more physical
symptoms that have no organic basis.

• Pain disorder
- has the primary physical symptom of pain,
which is generally unrelieved by analgesics and
greatly affected by psychological factors.
Somatic Symptom Disorders:

• Conversion disorder / Conversion reaction

- involves unexplained, usually sudden deficits in
sensory or motor function (e.g. blindness,
paralysis)

• Illness anxiety disorder (Hypochondriasis)

- preoccupation with the fear that one has a
serious disease (disease conviction) or will get a
serious disease (disease phobia).
 Somatic Conversion Pain Illness
symptom disorder disorder anxiety
disorder disorder

Occurrence More common in women

Onset Adolescence Between 10 Can occur at any age
until early and 35 years
adulthood old
(about 25
years of age)

Clinical Chronic or recurrent, lasting for decades

Course
Related Disorders

• Malingering
- the intentional production of false or grossly
exaggerated physical or psychological
symptoms; motivated by external incentives.

• Factitious disorder
- a mental disorder in which someone deceives
others by appearing sick, by purposely getting sick or
by self-injury; when family members or caregivers
falsely present others, such as children, as being ill,
injured or impaired.
Etiology

• Psychosocial theories
➢ internalization
➢ somatization

• Biologic theories
➢ amplified sensory awareness
Treatment

• Focuses on managing symptoms and

improving quality of life.

• SSRIs Antidepressants

• Pain management

• CBT
Nursing Diagnosis

• Ineffective coping
• Impaired social interaction
• Anxiety
• Disturbed sleeping pattern
• Fatigue
• Pain
Nursing Interventions

• Providing health teaching

Nurse: “Let’s take a walk outside for some fresh
air.” (encouraging collaboration)
Client: I wish I could, but I feel so terrible. I just
can’t do it.”
Nurse: “I know it is difficult, but some exercise is
essential. It will be a short walk.” (validation;
encouraging collaboration)
Nursing Interventions

• Providing health teaching

Client: “I just can’t eat anything. I have no
appetite.”
Nurse: “I know you don’t feel well, but it is important
to begin eating.” (validation; encouraging
collaboration)
Client: “I promise I’ll eat just as soon as I’m hungry.”
Nurse: “Actually. If you begin to eat a few bites, you’ll
begin to feel better, and your appetite may improve.”
(encouraging collaboration)
• Assisting the client in expressing emotions

• Teaching coping strategies

➢ emotion-focused coping strategies
➢ problem-focused coping strategies
Points to Remember!

• Carefully assess the client’s physical

complaints.

• Validate the client’s feelings while trying to

engage him or her in treatment.

• Remember that the somatic complaints are

not under the client’s voluntary control.