Somatoform Disorders

Somatoform disorders (synonyms: Anal spasm; skin neurosis; cardiovascular neurosis; cardiac neurosis; cardiac phobia; carcinophobia; colonic neurosis; nervous indigestion; nervous somatization; neurosis; neurovegetative dysfunction; neurovegetative dysregulation; neurovegetative dystonia; neurovegetative circulatory disorder; neurovegetative prostatic disorder; Pelvipathia spastica; pelvipathia vegetativa; pelvipathy; pelvipathy syndrome; somatization reaction; somatization disorder; somatoform pain disorder; somatoform disorder; undifferentiated somatization disorder; vegetative prostatic syndrome; teeth grinding (bruxism); ICD-10 F45. -: Somatoform disorders) describe a form of mental illness that results in physical symptoms without physical findings.

A somatoform disorder is present if the complaints, for which no somatic cause can be found, persist for at least six months and lead to impaired functioning in everyday life.

One can subdivide somatoform disorders according to various criteria, such as:

  • According to the duration and/or number of symptoms – oligo-/polysymptomatic.
  • According to the belief of the disease/fear of disease – hypochondriacal/amplifying.
  • By type of illness behavior such as number of doctor consultations, retirement requests, etc.

The duration until the diagnosis of somatoform disorders is usually three to five years.

Gender ratio: both sexes are affected, but women talk more often about the symptomatology.

Frequency peak: the disorder occurs predominantly in the 3rd decade of life. Children and adolescents may also be affected.

The prevalence (disease incidence) is 4-15% (in Germany). The lifetime prevalence (disease frequency during the whole life) is estimated at 80 % in Germany. Among hospitalized patients, approximately 30 % are affected.

Course and prognosis: Symptoms are often concentrated in a particular organ or system, e.g., the stomach (gastric neurosis) or the heart (cardiac neurosis). Not infrequently, the symptoms end spontaneously (on their own). In about 10% the disease runs chronically and leads to strong impairments in the everyday life of the affected person. Excessive diagnosis and therapy do not help with somatoform disorders.The prognosis of somatoform complaints is generally favorable. Tendentially, women seem to have a less favorable prognosis than men, and children and adolescents a more favorable prognosis than adults. Psychotherapeutic therapy started early has the best prognosis.

Comorbidities (concomitant diseases): in the context of severe courses, somatoform disorders are increasingly associated with depression, anxiety disorders, and addictive disorders.