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Somatoform disorders are a group of conditions where people experience physical pain which has no physiological basis. Thus, the person will generally become increasingly preoccupied with their health, will display increasingly negative emotions towards doctors, and will ask for more and more medical tests to be carried out on them.

There are specific criteria required in order to be diagnosed with somatoform disorder. These are: 

1.       The patient’s physical symptoms cannot be explained by a medical condition, an identified mental illness, or be the known side effects of taking some form of medication.

2.       The symptoms are not due to factitious disorder (where the person feigns or exaggerates symptoms for attention), or malingering disorder (where the person adopts symptoms for gain – such as avoiding certain social situations).

3.       The symptoms result is significant impairment in everyday functioning (social or occupational).

There are six categories of somatoform disorder. These are summarised as follows:

1.       Undifferentiated somatoform disorder: This is a mild form of the disorder. It is where the person complains of a single symptom for at least six months.

2.        Somatization disorder: This involves having a history of medical complaints before the age of 30. These include (i) pain and neurological symptoms (such as migraines and overwhelming fatigue), (ii) digestive problems (such as nausea, vomiting, stomach pains, constipation and diarrhoea) or (iii) sexual problems (such as loss of libido or pain during sex).

To qualify for this diagnosis, the person must experience pain in at least four different sites; have at least two different forms of gastrointestinal symptoms other than pain; and must have at least one pseudoneurological symptom (like fainting or blindness).

3.       Pain disorder: These people experience pain that has no known physical cause. This is usually chronic and disrupts their daily life.  

4.       Hypochondrias: Here, the person misinterprets normal body responses (such as a rumbling stomach) or minor symptoms (such as a tension headache) as meaning they are suffering from a very serious condition.

5.       Conversion disorder: With this condition, the person experiences neurological symptoms without a neurological cause. Examples include blindness, paralysis, dystonia, seizures, anesthesia, amnesia, swallowing difficulties, motor tics, and difficulty walking.

6.       Body dysmorphic disorder: An individual with this disorder is obsessed with a perceived flaw in their physical appearance. Although this is minor – or doesn’t exist at all - the person worries constantly about being judged on account of this imagined flaw. Common worries and obsessions include wrinkles, hair loss, weight gain, the size or shape of their eyes, nose or mouth, and the size of their breasts.

The cause of somatoform disorder is unknown. It may have to do with the nerve impulses that send the brain signals for pain. Biological factors may play a role, as well. For example, it has been suggested that people who suffer from this disorder may perceive and process pain differently, or be extremely sensitive to normal body processes. Interestingly, somatoform disorders tend to run in families – but it’s unclear whether this is due to nature or nurture. Also, it may be that the brain is converting anxiety signals into physical symptoms.

Treatments are generally focused around helping the person to manage the disorder. The goal is helping them to live as well as they can, even though they may experience chronic pain.