admin
Dr Sacrifice Chirisa Mental Health Matters
Somatic symptom disorder (SSD), formerly known as somatisation disorder, is a form of mental illness that causes one or more physical and bodily symptoms without it being traceable to a physical cause; including general medical conditions, other mental illnesses or substance abuse.But regardless, they cause excessive and a disproportionate level of distress. The symptoms can affect more than one organ and several body systems, such as:
Pain
Neurologic problems
Gastrointestinal complaints
Sexual symptoms
Many people who have this class of disorder will also have an anxiety disorder.
People with SSD cannot fake the symptoms due to its severity. The agony they experience from pain and other problems they experience are real, regardless of whether or not a physical explanation can be found. Also, the distress from symptoms significantly affects daily functioning.
Doctors may need to perform many medical tests including expensive radiological examinations to rule out other possible causes before diagnosing SSD.
The diagnosis of SSD can create a lot of stress and frustration for patients as they may feel unsatisfied if there is no better physical explanation for their symptoms or if they are told their level of distress relating to a physical illness is excessive.
Stress often leads patients to become more worried about their health, and this creates a vicious cycle that can persist for years.
Several conditions related to SSD are now described in psychiatry. These include;
Illness anxiety disorder: formerly called hypochondriasis. People with this type of disorder are preoccupied with a concern that they have a serious disease. They may believe that minor complaints are signs of very serious medical problems. For example, they may believe that a common headache is a sign of a brain tumor. They tend to go for doctor shopping as they seek to prove their own theory of the presence of a physical disease.
Conversion disorder: This is also called Functional Neurological Symptom Disorder. This condition is diagnosed when people have neurological symptoms that can’t be traced back to a medical cause. For example, patients may have symptoms such as:
Weakness or paralysis
Abnormal movements such as tremor or unsteady gait
Blindness
Hearing loss
Loss of sensation or numbness
Pain in a region of the body
Pseudocyesis: It is a false belief a woman has that she is pregnant along with other outward signs of pregnancy, including an expanding abdomen; feeling labour pains, nausea, foetal movement; breast changes; and cessation of the menstrual period.
Treatment
Patients who experience SSD may cling to the belief that their symptoms have an underlying physical cause despite a lack of evidence for a physical explanation.
Or if there is a medical condition causing their symptoms, they may not recognise that the amount of distress they are experiencing or displaying is excessive.
Patients may also dismiss any suggestion that psychiatric factors are playing a role in their symptoms. Thus they are referred late and may even refuse to come to be assessed by a psychiatrist.
A strong primary physician and patient relationship is key to getting help with SSD and convincing the patient of the need to see a psychiatrist. Seeing a psychiatrist early will save the patient from undergoing very expensive tests and examinations and in some not so rare cases multiple surgical operations.
The focus of treatment is on improving daily functioning, not only managing symptoms. Stress reduction is often an important part of the recovery process. Psycho-educating of the family and friends may also be useful.
DISCLAIMER:
This column contains information about mental health related issues. However, the information is not advice, and should not be treated as such. The writer accepts no responsibility for misuse and misrepresentation caused by the use or misunderstanding of this article. No warranties or assurances are made in relation to the safety and content of this article and attachments. Columnist accepts no liability for any damage caused by or contained in any attachments. No liability is accepted for any consequences arising from this article.
Dr S. M. Chirisa is a passionate mental health specialist who holds an undergraduate medical degree and postgraduate Master’s degree in psychiatry both from the University of Zimbabwe. He is currently working as a Senior Registrar in the Department of Psychiatry at Parirenyatwa Group of Hospitals and is also the current national treasurer of the Zimbabwe Medical Association (ZiMA). He can be reached at [email protected]
Online Reporter