Other Somatoform Disorders: Undifferentiated and Not Otherwise Specified

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  • 0:06 Somatoform Disorders
  • 1:35 Undifferentiated
  • 3:43 Not Otherwise Specified
  • 7:04 Lesson Summary
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Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

What happens when someone has physical symptoms without a physical cause? In this lesson, we'll look at undifferentiated and not otherwise specified somatoform disorders, including what they are and diagnostic issues surrounding them.

Somatoform Disorders

Jackie's daughter is dating a man that Jackie doesn't like or approve of. Ever since she found out that they were dating, about eight months ago, Jackie has been experiencing abdominal cramps and numbness in her right foot. They're really painful and have kept her out of work a lot. But, her doctor can't find anything wrong with Jackie.

Jackie might be experiencing a type of mental illness called somatoform disorders, which occur when a patient has physical symptoms without a physical reason for those symptoms.

There are many types of somatoform disorders, including undifferentiated somatoform disorder and somatoform disorder not otherwise specified. Undifferentiated somatoform disorder comes with one or more physical symptoms over an extended period of time. On the other hand, somatoform disorder not otherwise specified does not have the time requirement of the undifferentiated variety.

Many psychologists believe that somatoform disorders are caused, at least in part, by psychological stress. The patient takes their psychological pain and turns it into physical distress. For example, Jackie finding out that her daughter is dating a man she doesn't like could have caused her such distress that her mind converted that stress into physical pain in her abdomen and numbness in her foot.

Let's look closer at two somatoform disorders and some issues with diagnosing them.

Undifferentiated

Imagine for a moment that you are a psychologist. Jackie's doctor refers her to you because he can't find anything wrong with her despite the fact that she's in a lot of pain. When you first talk to her, you think that she might have somatization disorder, which is one type of somatoform disorder.

But wait! For you to diagnose Jackie with somatization disorder, she has to have a combination of at least four different pain symptoms: two different gastrointestinal symptoms, one sexual symptom, and one pseudo-neurological symptom. All Jackie has are abdominal cramps and foot numbness, so she can't have somatization disorder.

In response to the fact that sometimes patients don't present with all of those symptoms, the American Psychiatric Association came up with a new disorder called undifferentiated somatoform disorder. This syndrome is very similar to somatization disorder; the main difference is that it has fewer required symptoms.

For you to diagnose Jackie, she has to have at least one physical symptom that is not explained by a medical condition, or one physical symptom that is too intense to be explained by a medical condition. She can't be faking the symptoms, and they can't be part of another mental illness. Finally, the symptoms must have been present for at least six months and must cause her distress or impairment in her everyday life.

Jackie's doctor can't find anything wrong with her, but he's pretty sure she's not faking, and she doesn't have any other mental illness. She's been experiencing these symptoms for eight months, and they are keeping her from being able to live her life. Since she hits all of the criteria for undifferentiated somatoform disorder, you are able to diagnose her with it.

Treatment for the disorder is mostly focused on talking with Jackie and resolving issues that are underlying the syndrome. For example, you might work to try to make her feel better about her daughter's relationship or to change her thought patterns about it. In serious cases, antidepressant medications might also be prescribed.

Not Otherwise Specified

Jackie's daughter Rose thinks that she might be pregnant. She's used two different types of birth control with her boyfriend, but there's no denying it. She's got morning sickness. Her breasts are larger and more tender. She's missed several of her periods, and her stomach is growing larger. But, when she goes to the doctor, he says that she's not pregnant! What's going on?

When someone has some symptoms of a somatoform disorder but doesn't quite fit the criteria for it, they are diagnosed with somatoform disorder not otherwise specified. It's kind of a catch-all diagnosis for all the patients who are obviously suffering from a somatoform disorder, but can't be diagnosed because they have one or more criteria missing.

Somatoform disorder not otherwise specified is most commonly seen in three different circumstances:

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