Somatic Symptom Illnesses PDF

11/16/23, 11:04 AM Realizeit for Student Introduction In the early 1800s, the medical field began to consider the various social and psychological factors that influence illness. The term psychosomatic began to be used to convey the connection between the mind (psyche) and the body (soma) in state...

11/16/23, 11:04 AM Realizeit for Student Introduction In the early 1800s, the medical field began to consider the various social and psychological factors that influence illness. The term psychosomatic began to be used to convey the connection between the mind (psyche) and the body (soma) in states of health and illness. 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. Examples include diabetes, hypertension, and colitis, all of which are medical illnesses influenced by stress and emotions. When a person is under a lot of stress or is not coping well with stress, symptoms of these medical illnesses worsen. In addition, stress can cause physical symptoms unrelated to a diagnosed medical illness. After a stressful day at work, many people experience “tension headaches” that can be quite painful. The headaches are a manifestation of stress rather than a symptom of an underlying medical problem. 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 witchcraft, demons, and sorcerers. People with hysteria, usually women, were considered evil or possessed by evil spirits. Paul Briquet and Jean-Martin Charcot, both French physicians, identified hysteria as a disorder of the nervous system. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IfXgL26npJPT22aAWsq08u6Npe56xgiyh8MpUasnCQGXnd… 1/5 11/16/23, 11:04 AM Realizeit for Student Somatic symptom illnesses Sigmund Freud, working with Charcot, 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 (Esobar & Dimsdale, 2017). Overview of Somatic Symptom 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. The three central features of somatic symptom illnesses are as follows: Physical complaints suggest major medical illness but have no demonstrable organic basis. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IfXgL26npJPT22aAWsq08u6Npe56xgiyh8MpUasnCQGXnd… 2/5 11/16/23, 11:04 AM Realizeit for Student 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. Clients are convinced they harbor serious physical problems despite negative results during diagnostic testing. They actually experience these physical symptoms as well as the accompanying pain, distress, and functional limitations such symptoms induce. Clients do not willfully control the physical symptoms. Although their illnesses are psychiatric in nature, many clients do not seek help from mental health professionals. Unfortunately, many health care professionals who do not understand the nature of somatic symptom illnesses are not sympathetic to these clients’ complaints (Black & Andreasen, 2016). Nurses must remember that these clients really experience the symptoms they describe and cannot voluntarily control them. Somatic symptom disorders include (Esobar & Dimsdale, 2017): Somatic symptom disorder is characterized by one or more physical symptoms that have no organic basis. Individuals spend a lot of time and energy focused on health concerns, often believe symptoms to be indicative of serious illness, and experience significant distress and anxiety about their health. Conversion disorder, sometimes called conversion reaction, involves unexplained, usually sudden deficits in sensory or motor function (e.g., blindness, paralysis). These deficits suggest a neurologic disorder but are associated with psychological factors. There is usually significant functional impairment. There may be an attitude of la belle indifférence, a seeming lack of concern or distress, about the functional loss. Pain disorder has the primary physical symptom of pain, which is generally unrelieved by analgesics and greatly affected by psychological factors in terms of onset, severity, exacerbation, and maintenance. Illness anxiety disorder, formerly hypochondriasis, is preoccupation with the fear that one has a serious disease (disease conviction) or will get a serious disease (disease phobia). It is thought that clients with this disorder misinterpret bodily sensations or functions. Somatic symptom illnesses are more common in women than in men; they may represent about 5% to 7% of the general population, but estimates can vary greatly. Because most people with illness anxiety are seen in general medical or family practice settings, it is difficult to make accurate https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IfXgL26npJPT22aAWsq08u6Npe56xgiyh8MpUasnCQGXnd… 3/5 11/16/23, 11:04 AM Realizeit for Student estimates of occurrence. Reports of pain are one of the most common complaints in medical practice, and it is difficult to distinguish physical from psychological causation. Related Disorders Somatic symptom illnesses need to be distinguished from other body-related mental disorders such as malingering and factitious disorders, also known as fabricated or induced illness, in which people feign or intentionally produce symptoms for some purpose or gain. In malingering and factitious disorders, people willfully control the symptoms. In somatic symptom illnesses, clients do not voluntarily control their physical symptoms. Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms; it is motivated by external incentives such as avoiding work, evading criminal prosecution, obtaining financial compensation, or obtaining drugs. People who malinger have no real physical symptoms or grossly exaggerate relatively minor symptoms. Their purpose is some external incentive or outcome that they view as important and results directly from the illness. People who malinger can stop the physical symptoms as soon as they have gained what they wanted (Bass & Wade, 2019). Factitious disorder, imposed on self, occurs when a person intentionally produces or feigns physical or psychological symptoms solely to gain attention. People with factitious disorder may even inflict injury on themselves to receive attention. The common term for factitious disorder imposed on self is Munchausen syndrome (Quinn, Wang, Powsner, & Eisendrath, 2017). A variation of factitious disorder, imposed on others, is commonly called Munchausen syndrome by proxy and occurs when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a “hero” for saving the victim. An example would be a nurse who gives excess intravenous potassium to a client and then “saves his life” by performing cardiopulmonary resuscitation. Although factitious disorders are uncommon, they occur most often in people who are in or are familiar with medical professions, such as nurses, physicians, medical technicians, or hospital volunteers. People who injure clients or their children through Munchausen syndrome by proxy generally are arrested and prosecuted in the legal system. Factitious disorders are also called fabricated or induced illnesses. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IfXgL26npJPT22aAWsq08u6Npe56xgiyh8MpUasnCQGXnd… 4/5 11/16/23, 11:04 AM Realizeit for Student Munchausen syndrome by proxy Medically unexplained symptoms (MUS) and functional somatic syndromes are terms used more frequently in general medical setting. They refer to physical symptoms and limitations of function that has no medical diagnoses to explain their existence. There is overlap between these terms and somatic disorders diagnosed in mental health settings (Esobar & Dimsdale, 2017). MUS is often more acceptable to the patient because it does not have the connotation of “it’s all in your head” as do psychosomatic descriptors. Many patients are seen by general practitioners and are not involved in mental health settings. Effective treatment from patients’ perspectives includes being listened to and heard regarding symptoms, learning to cope with symptoms and limitations, learning to ignore some symptoms when possible, and positive response and support from providers (Sowinska & Czachowski, 2018). https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IfXgL26npJPT22aAWsq08u6Npe56xgiyh8MpUasnCQGXnd… 5/5