Approach to Somatic Symptom and Related Disorders

  • Kyung Bong Koh


The DSM-5 changed the term “somatoform disorders” to “somatic symptom and related disorders.” This new category includes the diagnoses of somatic symptom disorder, illness anxiety disorder, conversion disorder (functional neurological symptom disorder), psychological factors affecting other medical conditions (PFAOMC), and factitious disorder. DSM-5 emphasizes a positive criterion, namely, maladaptive reaction to a somatic symptom, instead of the earlier negative criterion, namely, that the symptoms should be medically unexplained. Assessment and management of each of these disorders along with risk factors were addressed. In addition, case examples related to each of somatic symptom and related disorders, particularly illness anxiety disorder, conversion disorder, and factitious disorder, were presented. Somatic symptom disorder was described in more detail in Chap.  14.


Somatic symptom and related disorders Somatic symptom disorder Illness anxiety disorder Conversion disorder (functional neurological symptom disorder) Psychological factors affecting other medical conditions (PFAOMC) Factitious disorder 


  1. 1.
    Van der Feltz-Cornelis CM, van Houdenhove B. DSM-5: from ‘somatoform disorders’ to ‘somatic symptom and related disorders.’. Tijdschr Psychiatr. 2014;56:182–6.PubMedGoogle Scholar
  2. 2.
    American Psychiatric Association (APA). Statistical and diagnostic manual of mental disorders. 5th ed. Washington, DC: Am Psychiatric Publishing; 2013.CrossRefGoogle Scholar
  3. 3.
    Sharma MP, Manjula M. Behavioral and psychological management of somatic symptom disorders: an overview. Int Rev Psychiatry. 2013;25:116–24.CrossRefGoogle Scholar
  4. 4.
    Barsky AJ. Somatoform disorders. In: Kaplan HI, Sodock BJ, editors. Comprehensive textbook of psychiatry. 5th ed. Baltimore: Williams & Wilkins; 1989. p. 1009–27.Google Scholar
  5. 5.
    Nettleton S, Watt I, O’Malley L, et al. Understanding the narratives of people who live with medically unexplained illness. Patient Educ Couns. 2005;56:205–10.CrossRefGoogle Scholar
  6. 6.
    Koh KB, Ki SW. A comparison of illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. Korean J Psychosom Med. 1997;5:185–94.Google Scholar
  7. 7.
    Ford CV, Smith GR Jr. Somatoform disorders, factitious disorder, and disability syndromes. In: Stoudemire A, Fogel BS, editors. Principles of medical psychiatry. Orlando: Grune & Stratton; 1987.Google Scholar
  8. 8.
    Ford CV. The somatizing disorders: illness as a way of life. New York: Elsevier; 1983.Google Scholar
  9. 9.
    Kenyon FE. Hypochondriasis: a survey of some historical, clinical and social aspects. Br J Med Psychol. 1965;38:117–33.CrossRefGoogle Scholar
  10. 10.
    Pilowsky I. Primary and secondary hypochondriasis. Acta Psychiatr Scand. 1970;47:484–509.Google Scholar
  11. 11.
    Schmale AH. Somatic expressions and consequences of conversion reactions. NY State Med J. 1969;69:1878–84.Google Scholar
  12. 12.
    Engel GC. Psychogenic pain and the pain prone patient. Am J Med. 1959;26:899–918.CrossRefGoogle Scholar
  13. 13.
    Lipsitt DR. Medical and psychological characteristics of crocks. Psychiatry Med. 1970;1:15–25.CrossRefGoogle Scholar
  14. 14.
    Barsky AJ, Klerman GL. Hypochondriasis, bodily complaints, and somatic styles. Am J Psychiatry. 1983;140:273–83.CrossRefGoogle Scholar
  15. 15.
    Katon W, Kleinman A, Rosen G. Depression and somatization: a review (part 1). Am J Med. 1982;72:127–35.CrossRefGoogle Scholar
  16. 16.
    Katon W, Kleinman A, Rosen G. Depression and somatization: a review (part 2). Am J Med. 1982;72:241–7.CrossRefGoogle Scholar
  17. 17.
    Cassem NH, Barsky AJ. Functional somatic symptoms and somatoform disorders. In: Cassem NH, editor. MGH handbook of general hospital psychiatry. 3rd ed. St Louis: Mosby Year Book; 1991.Google Scholar
  18. 18.
    Barsky AJ, Geringer E, Wool CA. A cognitive-educational treatment for hypochondriasis. Gen Hosp Psychiatry. 1988;10:322–7.CrossRefGoogle Scholar
  19. 19.
    Sadock BJ, Sadock VA. Synopsis of psychiatry – behavioral sciences/clinical psychiatry. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2003.Google Scholar
  20. 20.
    Caplan LR, Nadelson T. Multiple sclerosis and hysteria: lessons learned from their association. JAMA. 1980;243:2418–21.CrossRefGoogle Scholar
  21. 21.
    Merskey H, Buhrich NA. Hysteria and organic brain disease. Br J Med Psychol. 1975;48:359–66.CrossRefGoogle Scholar
  22. 22.
    Watson CG, Buranen C. The frequency and identification of false positive conversion reactions. J Nerv Ment Dis. 1979;167:243–7.CrossRefGoogle Scholar
  23. 23.
    Jones MM. Conversion reaction: Anachronism or evolutionary form: a review of the neurologic, behavioral, and psychoanalytic literature. Psychol Bull. 1980;87:427–41.CrossRefGoogle Scholar
  24. 24.
    Ludwig AM. Hysteria: a neurobiological theory. Arch Gen Psychiatry. 1972;27:771–7.CrossRefGoogle Scholar
  25. 25.
    Flor-Henry P, Fromm-Auch D, Tapper M, et al. A neuropsychological study of the stable syndrome of hysteria. Biol Psychiatry. 1981;16:601–26.PubMedGoogle Scholar
  26. 26.
    Halleck SL. Hysterical personality traits. Arch Gen Psychiatry. 1967;16:750–7.CrossRefGoogle Scholar
  27. 27.
    Celani D. An interpersonal approach to hysteria. Am J Psychiatry. 1976;133:1414–8.CrossRefGoogle Scholar
  28. 28.
    Barr R, Abernethy V. Single case study: conversion reaction: differential diagnosis in the light of biofeedback research. J Nerv Ment Dis. 1977;164:287–92.CrossRefGoogle Scholar
  29. 29.
    Hollender MH. Conversion hysteria: a post-Freudian reinterpretation of 19th century psychosocial data. Arch Gen Psychiatry. 1972;26:311–4.CrossRefGoogle Scholar
  30. 30.
    Hollender MH. Hysteria: the culture-bound syndromes. P N G Med J. 1976;19:24–9.Google Scholar
  31. 31.
    Engel GL. Conversion symptoms. In: Macbryde CM, Blacklow RS, editors. Sign and symptoms: applied pathologic physiology and clinical interpretation. 5th ed. Philadelphia: Lippincott; 1970.Google Scholar
  32. 32.
    Folks DG, Ford CV, Regan WM. Conversion symptoms in a general hospital. Psychosomatics. 1984;25:285–95.CrossRefGoogle Scholar
  33. 33.
    Hollander MH, Hersh SP. Impossible consultation made possible. Arch Gen Psychiatry. 1970;23:343–5.CrossRefGoogle Scholar
  34. 34.
    Stone MH. Factitious illness: psychological findings and treatment recommendations. Bull Menninger Clin. 1977;3:239–54.Google Scholar
  35. 35.
    Krammer KK, LaPiana FG, Appleton B. Ocular malingering and hysteria: diagnosis and management. Surv Ophthalmol. 1979;24:89–96.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Kyung Bong Koh
    • 1
  1. 1.Department of PsychiatryYonsei University College of MedicineSeoulKorea

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