When a patient presents with symptoms that have no apparent physical cause, a diagnosis of somatoform disorder should be considered. Stress, anxiety and depression can all involve physical symptoms.
The word ‘somatoform’ is a neologism that was created for inclusion in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). The term attempts to describe mental disorders that take the form of physical (or somatic) disease. However, use of the term ‘somatoform disorder’ is problematic because:
- it demands a categorical distinction between normal and abnormal, while it is likely that most people somatise from time to time
- it labels the bodily complaint a ‘mental’ disorder, which is generally not acceptable to patients and not useful in the context of developing a helpful therapeutic relationship.