SOMATOFORM DISORDER: FROM A LEGAL PERSPECTIVE

We have all experienced the occurrence of a somatoform symptoms whether or not we are aware of them. Consider when we are stressed and overworked. We feel like our "stomach is in knots" or that out "heads are pounding". What we are actually subjectively feeling is a painful or unpleasant physical reponse to a psychological or emotional state. Most of us are aware of the relationship between these physical symptoms and our psychological state and we do not impart medical significance on them. However, for some individuals these symptoms persist to the stage where they begin to cause significant distress or impairment in social, occupational or other areas of functioning and require serious attention. These individual’s suffer from a serious mental illness called Somatization Disorder.

Somatization Disorder is a condition that consists of diverse physical complaints with no detectable organic cause. To make the diagnosis the American Psychiatric Association’s current manual (DSM - IV) requires the presence of at least four physical symptoms that would normally be suggestive of a general medical condition. According to the DSM - IV the diagnostic features of Somatization Disorder are a history of pain and symptoms that relate at least four differrent sites (eg: the head, chest, back, extremites, joints) and functions (eg: menstruation, sexual intercourse, urination). There must be a history of physical complaints that begin prior to age 30 and last over several years. The individual must have sought treatment for these complaints and as a result the physical conditions have resulted in significant impairment in the individual’s social or occupational functioning. The most significant fact about Somatization Disorder is that the individual does in fact feel the pain and disabling symptoms. These individual are not feigning illness or malingering for secondary gain. In contrast to Factitious Disorder and Malingering the physical conditions the individual perceives are not intentional and not under the individual’s voluntary control.