A persistent complaint of pain or body problem without a physical cause, or the impairment is greater than would be expected from the physical findings. These people are not "lying" about or making up their illness; they believe that they are truly sick.

Alternative Names

Pain disorder; Body dysmorphic disorder

Causes, incidence, and risk factors

There is no specific cause, but stress or conflict may underlie the illness. The pain may have a special significance or may serve as a way to receive attention. People with this disorder may receive attention, sympathy or relief from responsibilities from others, or financial compensation from disability that may sustain the pain and behavior. Usually there is an anatomical change within the body as a result of disease or injury that is irreversible because multiple interventions to relieve the pain or abnormality have been unsuccessful. Chronic anxiety and depression may develop, with a corresponding decrease in the pain threshold.

Signs and tests

A physical examination and evaluation rules out a new physical illness as the cause for pain. Diagnostic testing may be involved depending on the nature of the symptoms. A psychiatric evaluation rules out related disorders.

Treatment

Generally, therapy is the most effective treatment for Somatoform Disorders. Because there is often no obvious physical reason for the pain or problems, invasive evaluations and surgical interventions should be avoided. Supportive measures for pain relief, such as hot and cold packs, physical therapy, distraction techniques, massage, relaxation techniques, can be helpful; long term use of analgesics and narcotics should be discouraged. Psychiatric referrals may be helpful, though many people with this disorder resist psychiatric interventions. There is often an underlying depression or anxiety disorder which may respond to antidepressants. Comprehensive treatment at pain centers may be of benefit for people with this disorder.

Expectations (prognosis)

People with a somatoform pain disorder rarely acknowledge that their illness has a psychological component and will usually reject psychiatric treatment, though when they finally have this insight, the results are often dramatic.

Complications

Sedative or analgesic dependence ( drug abuse and dependence ) can develop.

Calling your health care provider

Pain or perceived physical problems need a workup by a doctor; if the evaluation proves negative, it may be time to seek the aid of a chronic pain center or mental health professional.