Abstract
Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and clinical characteristics of each somatoform disorder and to examine the research assessing the efficacy of cognitive behavioral therapy (CBT) for each disorder. The review shows that CBT has received some empirical support for somatization, hypochondriasis, and body dysmorphic disorder. However, there are few data on the impact of treatment on health care use, especially when the cost of CBT is factored into the equation. Too few methodologically sound studies have been published on the treatment of conversion disorder or of pain disorder to make any conclusions.
Highlights
Somatoform disorders are characterized by physical symptoms that suggest a medical condition but that are not fully explained by a medical condition
The few investigators who have examined the epidemiology of somatoform pain disorder, instead of specific pain syndromes, have not assessed whether psychological factors were involved in the onset, severity, exacerbation, or maintenance of the pain, as required by DSM-IV
As is demonstrated in this chapter, a review of the research from the past 30 years indicates the clinical characteristics of patients meeting criteria for somatization disorder, undifferentiated somatoform disorder, pain disorder, and hypochondriasis are almost identical
Summary
Somatoform disorders are characterized by physical symptoms that suggest a medical condition but that are not fully explained by a medical condition. Many patients with somatoform symptoms are dissatisfied with the medical services they receive and repeatedly change physicians (Lin et al, 1991). Medicine has long recognized a group of patients with medically unexplained physical symptoms, excessive health concerns, and abnormal illness behavior, there has been and continues to be disagreement over precise diagnostic labels and criteria. The original DSM-III category of somatoform disorders included somatization disorder, hypochondriasis, conversion disorder, psychogenic pain disorder, and a residual somatoform disorder category (APA, 1980). Summarized is the research on the demographic and clinical characteristics of patients who meet criteria for somatoform disorders as well as the randomized controlled trials examining the efficacy of cognitive behavioral therapy (CBT) for somatoform disorders.
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