SOMATIC SYMPTOM

ILLNESSES

By: Group 3
INDEX
01 - Introduction
02 - Overview of Somatic Illnesses
03 - Etiology
04 - Treatment
05 - Community Based Care
06 - Mental Health Promotion
07 - Summary
 LEARNING OBJECTIVES
After the discussion the students will be able to:
explain what is meant by “psychosomatic illness”
describe somatic symptoms illnesses and identify their three central features
discuss the characteristics and dynamics of specific somatic symptom illnesses
distinguish somatic symptom illnesses from factitious disorders and
malingering
discuss the etiologic theories related to somatic symptom illnesses
01 - INTRODUCTION
In the 19th century, the medical field acknowledged
the influence of social and psychological factors on
human health. This evolving perspective led to the
introduction of the term "psychosomatic," signifying
the interconnectedness of the mind ("psyche") and
the body ("soma") in both healthy and diseased states.

Essentially, the mind can cause the body either to

create physical symptoms or to worsen physical
illnesses. Real symptoms can begin, continue, or be
worsened as a result of emotional factors
01 - INTRODUCTION

•The term HYSTERIA refers to multiple physical complaints with

no organic basis; the complaints are usually described
dramatically.

•The concept of hysteria is believed to have originated in Egypt and

is about 4.000 years old.

•In the Middle Ages, hysteria was associated with witch- craft,
demons, and sorcerers. People with hysteria, usually women, were
considered evil or possessed by evil spirits.
01 - INTRODUCTION
French physicians, Paul Briquet and Jean-Martin
Charcot identified hysteria as a disorder of the
nervous system.

In collaboration with Charcot, Sigmund Freud

observed that people with hysteria improved with
hypnosis and experienced relief from their
physical symptoms when they recalled memories
and expressed emotions.

This development led Freud to propose that

people can convert unexpressed emotions into
physical symptoms, a process now referred to as
Somatization.
02 - Overview of Somatic Illnesses
Somatization is defined as the transference of mental
experiences and states into bodily symptoms.

Somatic symptom illnesses can be characterized as the

presence of physical symptoms that suggest a medical
condition without a demonstrable organic basis to account
fully for them.
02 - Overview of Somatic Illnesses
THREE CLINICAL FEATURES OF SOMATIC ILLNESSES

•Physical complaints suggest major medical illness

but have no demonstrable organic basis.

•Psychological factors and conflicts seem important

in initiating, exacerbating, and maintaining the
symptoms

•Symptoms or magnified health concerns are not

under the client's conscious control.
02 - Overview of Somatic Illnesses
Somatic symptom disorders (Boland & Verduin, 2020)

Somatic symptom disorder

Functional neurological symptom disorder
Pain disorder
Illness anxiety disorder
Onset and Clinical Course:
Onset

Symptoms often begin in adolescence.

Diagnosis typically occurs in early adulthood (around 25
years old).
Functional neurological symptom disorder: 10-35 years old.
Pain disorder and illness anxiety disorder: any age.

Clinical Course

Chronic or recurrent, lasting for decades in many cases.

Help-seeking behavior
Seek multiple health providers
Related Disorders
Factitious disorder

also known as fabricated or induced illness

people pretends or intentionally produce symptoms for
some purpose or gain

Malingering

intentional production of false or grossly exaggerated

physical or psychological symptoms
it is motivated by external incentives such as avoiding work,
evading criminal prosecution, etc
Related Disorders
Factitious disorder, imposed on self
(Munchausen Syndrome)

occurs when a person intentionally produces or feigns

physical or psychological symptoms solely to gain attention
inflicts injury to self to gain attention

Factitious disorder imposed on others

(Munchausen Syndrome by proxy)

occurs when a person inflicts injury on someone else to gain

the attention of emergency medical personnel or to be a “hero
for saving them”
occurs mostly to those who are familiar with medical
professions
Related Disorders

Medically unexplained symptoms (MUS)

and functional somatic syndromes

These are terms used in medicine to describe physical

symptoms that have no identifiable organic cause, meaning
they can't be fully explained by underlying medical
conditions or pathology.
03- ETIOLOGY PSYCHOSOCIAL THEORIES

Psychosocial theories propose that individuals with these

disorders utilize internalization, an unconscious
defense mechanism, to manage stress, anxiety, and
frustration.

These internalized emotions are then expressed through

somatization, another unconscious defense mechanism,
manifesting as physical symptoms.

Difficulty expressing emotions verbally is common, with

some experiencing alexithymia, a condition characterized
by the inability to identify emotions.
03- ETIOLOGY
PSYCHOSOCIAL THEORIES

the direct internal benefits

PRIMARY GAINS that being sick provides, such
as relief of anxiety, conflict, or
distress.

the external or personal benefits

SECONDARY GAINS
received from others because one is
sick, such as attention from family
members and comfort measures
03- ETIOLOGY BIOLOGIC THEORIES

Research has shown differences in the way clients with somatoform disorders
regulate and interpret stimuli.

These clients cannot sort relevant from irrelevant stimuli and respond equally
to both types.

In other words, they may experience a normal body sensation such as

peristalsis and attach a pathologic rather than a normal meaning to it.

Too little inhibition of sensory input amplifies awareness of physical

symptoms and exaggerates response to bodily sensations.
04- TREATMENT
PATIENT CARE

• Build trust and empathy to reduce doctor shopping.

• Address potential depression or anxiety with
medication (e.g., SSRIs).

PAIN MANAGEMENT

• Consider chronic pain clinics for pain management

techniques (relaxation, imagery).
• Physical therapy can improve function and muscle
tone.
• Avoid narcotic pain relievers due to addiction risk.
Use NSAIDs for pain relief.
 04- TREATMENT

THERAPY
Support groups which offers:
- peer support
- coping strategies
ed to - emotional expression skills.
"We ne
m a n ag e Cognitive-behavioral therapy (CBT)
learn to
ot io ns"
ou r e m
PATIENT EDUCATION
Inform patients about their condition to
reduce anxiety.
Educational sessions can be offered in
primary care settings.
05 - COMMUNITY BASED CARE
Nursing Interventions for Somatic Symptom Illnesses
•Health teaching

•Expression of emotional feelings

•Recognized coping strategies (emotion-focused and

problem-focused)
06 - MENTAL HEALTH PROMOTION

People who have somatic symptom illnesses express

themselves through physical symptoms. Since, these
clients are better if they are able to express their
emotions and needs directly, their physical
symptoms subside so it's important to assist them in
dealing with emotional issues directly for mental
health promotion.
06 - MENTAL HEALTH PROMOTION

"It is important to pay

attention to our mental
health"
06 - MENTAL HEALTH PROMOTION
CYBERCHONDRIA

excessive or repeated online searches for

health-related information that is distressing or
anxiety-provoking for the person (Starcevis et
al., 2020).
SELF - AWARENESS

The nurse must not respond with the patient’s anger and outbursts or
criticism.
The nurse should be realistic about the small successes that can be
achieved in any given period.
The nurse must enhance the ongoing relationship by accepting the
client and their continued complaints and criticisms while remaining
nonjudgmental
 06 - MENTAL HEALTH PROMOTION
Points to Consider When Working With Clients With
Somatoform Disorders

Comprehensive Assessment
- conduct a thorough evaluation of the client's physical complaints,
avoiding dismissal or assumptions of psychological origin.

Validation and Engagement

- acknowledge the client's feelings while encouraging participation in
treatment through reflective and engaging communication.

Holistic Approach
- recognize that symptom reduction often coincides with improvements
in coping skills and interpersonal relationships
06 - SUMMARY
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.
 "It is important to pay
attention to our mental
health"

"We can seek help from a

professional"
QUIZ
1. ) Sarah has been spending an excessive amount of
time online searching for information about her
health symptoms. This is referred to as:

a.Hypochondriasis
b. Chondrosis
c. Cyberchondria
d. Controlling Cyberchondria
2.) Termed as the greek for wandering uterus
associated often with women.

a.Hysteria
b.Hysteroma
c.Soma
d.Hysterestia
3.) Client has been experiencing a lot of stress lately
due to work and personal issues. Frequent headaches,
stomachaches, and trouble sleeping. This is referred to
as:

a.Somatization
b.Internalization
c.Alexithymia
d.Externalization
4.) Clients are unlikely to be able to think about or
respond to questions about emotional feelings. They
will answer questions about how they feel in terms of
physical health or sensations.

a.Mood and Affect

b.Self- concept
c. Sensorium and intellectual Processes
d. Thought process and Content
 5.) Clients describing a series of personal crises
related to their physical health may appear pleased
rather than distressed about these situations.

a. General appearance and motor behavior

b. Self concept
c. Mood and affect
d. Judgement and Insight
6.) Nurse Chloe is caring for Claire who has somatic illness whom
also is always have complaints and criticisms, nurse Chloe knows
that the best way to deal with Claire is to

A.Accept the client’s complaints and criticisms while remaining

nonjudgemental.
B.Tell Claire to stop complaining
C.Ignore Claire’s complaints and criticisms
D.Be judgemental and assume that Claire is selfish
7.) Which behavior by a patient would not support a
diagnosis of somatoform disorder?

a.Avoiding certain unpleasant activities

b.Seeking attention from significant others
c.Acquiring financial gain from a disability plan
d.Performing activities of daily living unassisted
 8.) A nurse is caring for a young widow and suggests
community resources available to help her cope with
the loss. Why is this intervention important?

a.To identify anxiety

b.To identify a support system
c.To assess suicidal tendency
d.To build a relationship with the patient
9. ) French physicians, Paul Briquet and Jean-Martin Charcot
identified hysteria as a disorder of the?

A.) nervous system

B.) digestive system
C.) Integumentary system
D.) Circulatory system
 10.) Which interventions does the nurse use when caring for a
patient demonstrating the inability to provide effective self-
care?

a.Initially sets only minimal self-care expectations for the

patient
b.Identifies the patient's highest level of self-care and states
reasonable expectations to the patient
c.Identifies the level of self-care the patient is willing to perform
and sets expectations accordingly
d.Attends to all self-care needs until the patient indicates a
willingness to perform care independently
11.) A patient is admitted with reports of abdominal pain,
dizziness, and headaches. Results of a physical workup have
been negative. Today the patient tells the nurse, "Now I am
having back pain." Which assessment interview data may alert
the nurse to the possibility of malingering? Select all that apply.

a.The patient was adopted at the age of 5 years.

b.The patient was raised primarily by a single parent.
c.The patient has a court date this week for drunk driving.
d.The patient has a history of oppositional-defiant disorder.
e.The patient has a history of physical abuse by his or her
stepfather.
12 .) Factitious disorder is characterized by:

A) Genuine physical symptoms with no medical explanation

B) Intentionally faking or producing physical or psychological
symptoms
C) Excessive worry about having a serious illness
D) Symptoms that are culturally appropriate
13.) During an assessment the nurse notes that a patient has a
"crisscrossed" abdomen. In which illness or disorder is a
crisscrossed abdomen commonly seen?

a.Diarrhea
b.Constipation
c.Anorexia disorder
d.Factitious disorder
14.) A nurse is caring for a client who exhibits chronic physical
symptoms that cannot be fully explained by medical conditions.
These symptoms cause distress and impairment in the client's
daily life. What term is used to describe this condition?

a.Illness anxiety disorder.

b.Conversion disorder.
c.Somatic symptom disorder.
d.Factitious disorder.
15.) A nurse is providing care for several clients with somatic
symptom illnesses. Which of the following clients is most likely
to have illness anxiety disorder?

a.A client with altered motor functions and sensory symptoms.

b.A client intentionally producing physical symptoms for
attention.
c.A client preoccupied with having a serious illness despite
minimal symptoms.
d.A client experiencing chronic physical symptoms with
excessive responses.
Thank You!