What is a somatic disorder

Somatoform disorders

Sometimes we feel like there's a lump in our throat. Such discomfort often goes away on its own. But if it persists for a long time and has no organic cause, it can be a somatoform disorder.

Definition and characteristics of a somatoform disorder

Somatoform disorders are physical complaints, the no organic cause to have. The symptoms have been present for several months or even years.

Somatoform complaints are differentiate from psychosomatic disordersfor which clear organic findings are available.

It is characteristic of those affected that, despite unsuccessful medical consultations, they repeatedly request new physical examinations. Often, in patients with a somatoform disorder, what is known as “doctor hopping” can be observed, which comes from the difficult relationship between those affected and the practitioner The result: On the one hand, the patient feels badly advised by the doctor, because the doctor does not manage to eliminate the symptoms. On the other hand, the doctor perceives the patient as complicated, as he often refuses to investigate the cause of the soul despite negative physical findings. As a result, patients continually seek out new doctors, which in turn is followed by the “fat file syndrome”.

to shape

Somatoform disorders are among that ICD code F45 classified. When the disease is particularly between the following Subtypes differentiated:

Somatization disorder (F 45.0)

this is the heaviest expression of somatoform disorders. According to ICD-10, at least six different, changing symptoms are complained about over a period of two years. The complaints are diffuse, so they are perceived throughout the body. The affected suffer immensely and have seen several doctors. Your everyday professional and social life is severely affected.

Undifferentiated somatization disorder (F 45.1)

This is a milder form the aforementioned somatization disorder. The undifferentiated somatization disorder can be detected after just six months of illness and has fewer and less pronounced symptoms.

Hypochondriac disorder (F 45.2)

In hypochondriac disorder, the patient has been away for at least six months convinced to be seriously ill. He concentrates more on this conviction than on the symptoms themselves. There is also the body dysmorphic disorder in which the affected patient perceives himself as disfigured or malformed (F 45.21).

Somatoform autonomic dysfunction (F 45.3)

With this disorder, the functions of a certain organ system of the autonomic nervous system are perceived as defective. Most of them are affected

  • the cardiovascular system,
  • the upper digestive system,
  • the lower digestive system,
  • the respiratory system and
  • the genitourinary system.

Persistent somatoform pain disorder (F 45.40)

There is severe pain in at least one part of the body. A distinction is made between the Pain disorder with and without an organic cause. Although a physical cause can be identified in the chronic pain disorder (F 45.41), which has existed for over six months, the pain is felt to be stronger due to emotional stress.


So far, no clear cause of the development of somatization disorders is known. However, it is believed that doing so biological, psychological, social and genetic factors playing together.

Often these extend into the childhood back: Those affected often experienced an imbalance between risk and protective factors at a young age, were given certain models of coping with illness or were victims of traumatizing experiences such as sexual abuse.

But even in adulthood, various psychological conflicts contribute to somatoform disorders: These include, for example

  • unprocessed grief,
  • repressed fears or
  • suppressed anger.

It is believed that excessive (emotional) stress to overload and disturbance of internal organs can lead. This sets in motion a vicious circle of physical reactions, the resulting fear and an increasingly sensitive perception of one's own body processes.


The symptoms of a somatoform disorder are many. Often standing Pain in the foreground. Depending on the form and intensity of the disorder, symptoms range from

  • general complaints such as tiredness, exhaustion and dizziness
  • general and specific pain
  • up to breathing difficulties,
  • Gastrointestinal problems,
  • Cardiovascular disorders
  • sexual and urological complaints
  • up to (pseudo) neurological symptoms.

In addition to somatization disorders, other psychological disorders such as depression and / or anxiety disorders often occur.

Diagnosis of somatoform disorders

To diagnose somatoform disorders, doctors often turn to Simultaneous diagnostics at. The following applies:

  • to exclude organic causes for the complained complaints by means of physical examinations
  • uncover the psychological origins of body symptoms

So that they psychological history Doctors ask patients about their emotional and emotional life: for example, are there psychological conflicts and / or biographical burdens? In addition, those affected can contribute to the diagnosis by completing a self-disclosure questionnaire.


Basically: The prerequisite for a successful therapy is a stable one Relationship of trust between patient and doctor. The family doctor in particular plays a key role for those affected, because he is not only a practitioner, but also an intermediary (to specialists and physiotherapists) and motivator (for taking up relaxation and / or sports training).

Treatment eventually settles according to shape and weight the somatoform disorder:

Mild symptoms are often already means Relaxation techniques treatable. Effective methods against stress include, among other things

  • therapeutic writing,
  • Meditation,
  • Mindfulness training, yoga and
  • Autogenic training.

In order to gain an understanding of psychosomatic processes, it also makes sense for the doctor to explain the relationships between psyche and body to the patient.

Are the Complaints more persistent, become psychosomatic medicine and psychotherapy combined. Mental conflicts are to be tracked down and viewed in connection with the somatic disorders. Stressful physical symptoms are caused by physical therapy made more bearable. Medicines are only used for particularly severe symptoms. More complex cases become inpatient in psychosomatic clinics treated.

It is not always possible to eliminate all symptoms. It is therefore important to convey to those affected not to perceive every perceived bodily function as a symptom of illness. The patient should develop a feeling that health does not mean being free of symptoms. The goal is that to create the best possible quality of life and consolidate

Post-treatment rehab

In order to remain gainfully employed or to become (again) employable, rehabilitation in a psychosomatic clinic is possible after the treatment. By means of this measure in particular the Prevents chronification of somatoform disorders become.

In rehab there is usually one multimodal, so diverse, treatment: In addition to psychosomatic medicine, psychotherapeutic treatment and physiotherapy, relaxation techniques are used.

Prevalence and prognosis

Somatoform complaints are common: they do, for example twenty percent of all general practitioner consultations out. Along with depression and anxiety disorders, they are the most common mental disorders.

The “real” somatization disorder with the strongest symptoms is rarely diagnosed. The most common, however, is the unspecific somatization disorder.

The sooner a somatization disorder recognized and treated becomes, all the cheaper is the forecast. A careful combination of physical examination, psychological therapy and stress-relieving relaxation methods can in many cases alleviate or even eliminate symptoms.

Somatoform disorder: the sooner it is recognized, the more likely it is to be banished

Not every lump in the throat is a somatoform disorder. Every somatoform symptom, on the other hand, is an indication of psychological stress. If there are no organic causes of persistent physical discomfort, it is likely that ours overloaded soul sounds the alarm and calls for relief. The faster we comply with this requirement, the faster our physical complaints will improve.

Article edited by the Rehabilitation Expert Committee, April 9th, 2020

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