Somatic Symptom and Dissociative Disorders

Alterations in Health

• Clients experience physical symptoms or disruptions in identity, memory, or consciousness without a fully explained medical cause.

• These symptoms cause significant distress or impair daily functioning.

• Health alterations are more psychological in origin but are perceived as very real to the patient.

Epidemiological and Etiological Risk Factor

Somatic Symptom Disorders

• More common in women and often begin in adolescence or early adulthood.

• Linked to chronic stress, childhood trauma, family history of illness or anxiety, and learned behaviors(attention from being “sick”).

• May co-occur with depression or anxiety.

Dissociative Disorders

• Often associated with severe trauma, especially childhood abuse (physical, sexual, or emotional).

• May be a coping mechanism to separate from painful memories or experiences.

• Can be triggered by stressful events later in life.

Somatic Symptom Disorder

• Multiple, persistent physical complaints (pain, fatigue, GI symptoms) with excessive preoccupation or anxiety about health.

• Symptoms are not intentionally produced.

• Frequent healthcare visits with no clear medical explanation.

Illness Anxiety Disorder (Hypochondriasis)

• Preoccupation with having or developing a serious illness despite minimal or no physical symptoms.

• Health-related anxiety dominates life activities.

Conversion Disorder (Functional Neurological Symptom Disorder)

• Loss or alteration of motor or sensory function (e.g., paralysis, blindness, seizures) without medical cause.

• Often follows psychological stress or trauma.

Factitious Disorder (Munchausen Syndrome)

• Intentional fabrication or exaggeration of symptoms for psychological gain (to assume the sick role).

• Not for money or external benefit (that would be malingering).

Dissociative Disorders

• Dissociative Amnesia: Inability to recall important personal information, usually related to trauma.

• Dissociative Fugue: Sudden travel away from home with inability to recall identity or past.

• Dissociative Identity Disorder (DID): Two or more distinct identities or personalities.

• Depersonalization/Derealization Disorder: Feeling detached from self or environment.

Nursing Interventions somatic 

Effective therapeutic communication

• Develop healthy coping strategies

and skills

• Encourage health lifestyle

• Psychosocial education

Nursing Interventions: Dissociative Disorder

Effective therapeutic communications

• Empathic therapeutic relationship

• Develop healthy coping strategies and skills

• Maintain boundaries and set limit