Undifferentiated Somatoform Disorder

Somatoform disorders in general are psychological disorders that suggest organic disease but, upon examination, do not present the appearance of organic disease; an example would be hypochondrism. Undifferentiated somatoform disorder is one in which the physical complaints of the patient are clearly caused by psychological issues rather than physical ones, but in which the symptoms do not point toward a specific somatoform disorder. For instance, a woman who shows all the symptoms of pregnancy (from lack of menstruation to nausea) but who is not pregnant and who does not exhibit any other somatoform disorder symptoms would be classified as an undifferentiated somatoform disorder patient.

Like all somatoform disorders, undifferentiated somatoform disorder is caused by an underlying neurosis, often a painful incident from childhood that has never been addressed. In the pregnancy example above, the patient is likely someone who desperately wants to have a child but who has been unsuccessful at conceiving. A person convinced that he or she has been cursed by a witch (which happens in African and  Caribbean cultures) may present serious somatoform disorders, sometimes even life-threatenting ones.

Undifferentiated somatoform disorder is treated through psychotherapy, especially in addressing the desires and fears that caused the disorder to begin with. The psychotherapist uses a variety of techniques to bring out the unaddressed issues in the context of a therapeutic session, and the patient, in dealing with those issues, gradually gets better. Drugs may have a place in undifferentiated somatoform disorder, particularly when the patient may act in ways dangerous to himself or herself and others.

One of the greatest dangers in a somatoform disorder is when the patient tries to make it more real. There have been instances where a woman who convinces herself and others that she is pregnant will go out and murder a real pregnant woman in order to take the baby; this is, of course, an extreme. There have also been cases where a person experiencing somatoform-related pain in a limb will attempt to have it amputated, and if turned down, will seek to amputate it him or herself. Perhaps surprisingly, this sometimes does bring the patient relief – but at a very high cost to himself.

The outlook for undifferentiated somatoform disorder really depends on how successful the psychotherapeutic interventions are. If the psychotherapist is successful at evoking and helping the patient work through the underlying mental issue, undifferentiated somatoform disorders will go away. If, however, the psychotherapist cannot, whether because the patient is resistant or because it’s just too far buried, the prognosis may not be good.

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