Psychosomatic Disorder

What is a psychosomatic disorder?

Psychosomatic disorder is a psychological condition involving the occurrence of physical symptoms, usually lacking a medical explanation. People with this condition may have excessive thoughts, feelings or concerns about the symptoms — which affects their ability to function well.

People with psychosomatic disorder usually don’t report overt symptoms of psychiatric distress. Instead, they believe their problems are caused by medical conditions. They tend to visit healthcare providers frequently to get tests and treatments, often not receiving a diagnosis, which may lead to frustration and distress.

Psychosomatic disorder is sometimes called somatic symptom disorder, somatic symptoms or somatic pain.

How common is somatic symptom disorder?

Somatic symptom disorder is common, occurring in about 5% to 7% of the general population. For reasons that are not understood, women have somatic pain about 10 times more often than men.

Who might have somatic symptoms?

Anyone can have somatic symptoms at any age.

Studies have found that certain things may make people more likely to have somatic symptoms:

• Chaotic lifestyle.
• Difficulty recognizing and expressing emotions.
• Childhood neglect.
• History of sexual abuse.
• Other psychological conditions, such as depression or personality disorders.
• Substance abuse (such as alcoholism or drug addiction).
• Unemployment.

How can psychosomatic disorder affect my body?

Psychosomatic disorder can affect almost any part of the body. Common examples include:

• Fatigue
• Insomnia
• Aches and pains, such as muscle pain or back pain.
• High blood pressure (hypertension).
• Trouble breathing (dyspnea, or shortness of breath).
• Indigestion (upset stomach).
• Headaches and migraines.
• Erectile dysfunction (impotence).
• Skin rash (dermatitis).
• Stomach ulcers (peptic ulcer disease).

What causes psychosomatic symptoms?

Scientists aren’t sure. Some believe that stress releases hormones and chemicals in the body that cause damage or dysfunction.

What are the symptoms?

In addition to the somatic symptom itself (for example, pain or upset stomach), people with psychosomatic disorder often:

• Become angry or irritable because they believe their medical needs aren’t being met.
• Get depressed or anxious.
• Visit healthcare providers frequently, often jumping from one physician to another.
• Experience difficulties functioning at work, school or socially.

How is psychosomatic disorder diagnosed?

A healthcare provider can begin to diagnose psychosomatic disorder based on:

• History of visits to healthcare providers.
• Physical exam.
• Series of negative results on tests.

To be diagnosed with somatic symptom disorder, a person must have:

• One or more symptoms that are distressing or disruptive to daily life.
• A history of those symptoms for at least six months.
• Persistent thoughts, worries or anxiety about the symptoms.

What tests might I have for psychosomatic disorder?

A healthcare provider might order some tests to rule out other medical conditions, such as blood tests or imaging. But when healthcare providers believe that symptoms are psychosomatic, they usually don’t order any tests. Instead, they try to protect their patients from the stress and expense of unnecessary tests and procedures.

How are psychosomatic pain and other somatic symptoms treated?

Several treatments can help people with somatic pain symptoms, including:

• Cognitive behavioral therapy.
• Medications, such as antidepressants.
• Mindfulness-based therapy.
• Referral to a specialist in mental health (for example, a psychiatrist or psychologist).
• Regular contact with your primary care provider.

How can I prevent psychosomatic disorder?

Strategies to reduce and manage stress may help you prevent or lessen somatic symptoms. Examples include:

• Be realistic about what you can and can’t control.
• Exercise regularly.
• Get enough sleep.
• Journal to increase awareness of your thoughts and feelings.
• Limit alcohol and avoid smoking.
• Maintain a healthy diet and weight.
• Meditate or practice progressive muscle relaxation.
• Seek support from loved ones.
• Set limits to reduce pressure on yourself.

What is the outlook for people with psychosomatic disorder?

Many people learn to control and lessen somatic pain symptoms over time. However, even with treatment, psychosomatic symptoms may come and go throughout life.

What else should I ask my healthcare provider about psychosomatic symptoms?

If you’ve been diagnosed with psychosomatic disorder, consider asking your healthcare provider:

• What’s causing these symptoms?
• How can I relieve them?
• Should I talk to a specialist in mental health?
• When should I seek medical care?
• How do I know if I’m having an emergency?
• How often should I see my primary care provider?
• How can my family and friends help me?

A note from Cleveland Clinic

Psychosomatic disorder is a psychological condition. It leads to physical symptoms, usually without any other medical explanation or diagnosis. It can affect almost any part of the body. People with somatic symptoms often seek frequent medical attention for tests and treatments. They tend to become increasingly worried or anxious. It’s important to know that somatic symptom disorder is not the same as “faking it” or exaggerating symptoms. They're real and distressing symptoms — the origin just happens to be psychological instead of medical. If you have long-lasting, unexplained symptoms, talk to your healthcare provider. Behavioral therapies and lifestyle changes can help. They can also prevent unnecessary tests and treatments.