Somatoform Disorders / Edition 1

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Be Guided by the Evidence...

Somatoform disorders are more common than many clinicians realize and are often underdiagnosed and poorly managed.

This practical guide provides a comprehensive overview of all somatoform disorders. It aims to enable the mental health practitioner to properly diagnose and manage the disorders as well as to provide the appropriate advice to colleagues of other medical disciplines.

Somatoform Disorders offers:
* Detailed coverage of the concepts of each disorder: diagnosis, classification, co-morbidities and course and outcome
* An outline of clinical, biological and psychosocial research in the area
* An overview of clinical management and future perspectives
* The unique series format of systematic reviews followed by commentaries

Somatoform Disorders is the ninth volume of the WPA Series "Evidence and Experience in Psychiatry. The book is an unbiased and reliable reference point for all psychiatrists, psychologists, mental health nurses and policy makers.

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Editorial Reviews

Doody's Review Service
Reviewer: Michael Joel Schrift, DO, MA (University of Illinois at Chicago College of Medicine)
Description: Somatoform disorders hold a special place in the history of psychiatry, neurology, and medicine but they remain controversial; perplexing conceptually; a diagnosis essentially based on dualism; a diagnosis that often rests upon the clinician making a correct inference of the patient's intentions; lack validity studies except for, possibly, somatization disorder; extremely frustrating to the clinician and the patient's family; a burden on the healthcare system, and are difficult to treat. This book addresses these vexing issues head-on. The editors and authors critically review and bring the reader up-to-date in the current understanding of this important group of illnesses. Written and edited by a group of internationally recognized authorities in this area, the book is an outstanding contribution to the psychiatric literature.
Purpose: The purpose of the book, according to the editors, is to provide a comprehensive overview of all somatoform disorders in order to help clinicians in the proper diagnosis, management, and consultation of patients with these problems.
Audience: The intended audience includes "...psychiatrists, psychologists, mental health workers, and mental health policy makers." Primary care physicians and neurologists would also benefit from reading this book.
Features: The topics covered in the six chapters include syndromes and illnesses beyond the DSM boundaries of somatoform disorders. Areas included are somatization and conversion disorders, pain disorder, hypochondriasis, body dysmorphic disorder, chronic fatigue and neurasthenia, and factitious physical disorders. Each topic is reviewed in depth and with an international perspective. The chapters are written in a scholarly fashion and end with relevant citations of the scientific literature. The index is helpful.
Assessment: This is an informative and comprehensive new book on a group of common but difficult disorders. The book should be read by all clinicians. I highly recommend it.
From the Publisher
"…an informative and comprehensive new book on a group of common but difficult disorders. The book should be read by all clinicians. I highly recommend it." (Doody's Health Services)
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Product Details

Meet the Author

Mario Maj, Department of Psychiatry, Clinica Psichiatrica, Primo Policlinico Universitario, Naples, Italy. Is also president of the Association of European Psychiatrists.

Hagop S. Akiskal, University of California at San Diego, La Jolla, CA, USA, professor of Psychiatry and Director of International Mood Center.

Juan E. Mezzich, International Center for Mental Health, Mount Sinai School of Medicine, NYU,New York NY

Ahmed Okasha, Institute of Psychiatry, Ain Shams University, Cairo, Egypt, Director of WHO Collaborating Center

All are previous editors of WPA Series

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Table of Contents

List of Reveiw Contributors.



Somatization and Conversion Disorders: A Reveiw (Harold Merskey and Francois Mai).


1.1 From Hysteria to Somatization Francis Creed.

1.2 Somatoform and Conversion Disorders or Somatic Presentations of Mental Disorders (Javier J. Escobar).

1.3 Are Somatoform Disorders a Distinct Category? (Gregory E. Simon).

1.4 Somatoform Disorders: Deconstructing a Diagnosis (Oye Gureje).

1.5 The Psychbiology of Somatization and Conversion Disorders (C. Robert Cloninger and Mehmet Dokucu).

1.6 Patient or Process (Linda Gask).

1.7 Reading the Body (Leslie Swartz).

1.8 Somatization and Conversion Disorders: A Forgotten Public Health Agenda (Shekhar Saxena).

1.9 A Cognitive Account on Conversion and Somatization Disorders (Karin Roelofs).

1.10 Labelling the Unfathomable (Bart Sheehan).

1.11 Somatization and Conversion: An Ongoing Controversy (Carsten Spitzer and Hans Jorgen Grabe).

1.12 The Mind-Body Dualism and Conversion Disorders (Carlo Faravelli and Massimo Lai).

1.13 Concepts of Medically Unexplained Symptoms in Relation to Mind-Body Dualism (Athula Sumathipala).

1.14 A Challenge for Both Clinicians and Researchers (Antonio Lobo).

1.15 Somatization Disorders in the African Context (Frank G. Njenga, Anna N. Nguithi and Rachel Kang'ethe).

1.16 Somatization and Conversion Disorders: An Arab Perspective 9Tarek A. Okasha).

1.17 Much Theory, but Little Agreement (Alberto Perales and Hector Chue).


Pain Disorder: A Reveiw (Steven A. King).


2.1 The Major Paradigm Shift from the Biomedical Reductionist to the Biopsychosocial Approach to the Assessment and Treatment of Pain (Robert J. Gatchel).

2.2 DSM and Pain: When (if ever) is Pain  Truely a Psychiatric Disorder? (Robert Boland).

2.3 Pain Disorder or Just Pain: Can We Escape Dualism? (Robert G. Large and Tipu Aamir).

2.4 The Mind-Body Ditchotomy in the Modern World (Hans Jorgen Grabe and Cartsen Spitzer).

2.5 Chronic Pain: Towards a Biopsychosocial Perspective (Michael Bach and Martin Aigner).

2.6 Pain Disorder: Where's the Utility? (Lance M. McCracken).

2.7 Patients must be at the Centre of Pain Management (Joanna M.Zakrzewska).

2.8 Chronic Pain: the Importance of a Comprehensive History (Gerald M. Aronoff).

2.9 Psychological and Physiological Factors in Pain Disorder (Morten Birket-Smith).

2.10 Does the Somatoform Disorder Approach Broaden Our Perspective on Pain? (Wolfgang Hiller and Paul Nilges).

2.11 Diagnosis and Treatment of Pain: Consultation-Liason Psychiatry Aspects (Albert Diefenbache)r.

2.12 Pain: Suffering, Semantics, and Sensitization (Jeffrey Rome).

2.13 Subjectivity and Communitas: Further Considerations on Pain (Etzel Cardena).

2.14 The Relationship Between Pain and Anxiety Disorders (Antonio Bulbena, Carlos Garcia Ribera and Lili Sperry).

2.15 Gaps in Evidence Base of Pain Disorders (Santosh K. Chaturvedi).

2.16 Pain in Genral Practice (Manual Suarez Richards and Gustavo Alfredo Delucchi).


Hypochondriasis: A Reveiw (Russell Noyes Jr).


3.1 Hypochondriasis: Future Directions in Classification and Etiology Research (Steven Taylor and Gordon J.G. Asmundson).

3.2 Making Sense of Hypochondriasis (Jonathan S. Abramowitz).

3.3 Hypochndriasis: An Endless Source of Controversies (Vladan Starcevic).

3.4 Hypochondriasis: Defining Boundaries, Exploring Risk Factors and Immunology (Eamonn Ferguson).

3.5 Hypochondriasis, Health Anxiety, and Cognitive-Behavoural Therapy (Patricia Furer and John R. Walker).

3.6 Progress with Hypochondriasis (Theo K. Bouman).

3.7 The Clinical Spectrum of Hypochondriacal Fears (Giovanni A. Fava and Stefania Fabbri).

3.8 A Nosological Nightmare (Geoffrey G. Lloyd).

3.9 Hypochondriacal Syndromes: Where Did They Go? (Driss Mousaoui).

3.10 Dimensional Versus Categorical Approach to Obsessions, Delusions, and Hypochondriasis (Joseph Zohar).

3.11 The Nosographic Complexity of Hypochondriasis and the Ambiguilty of the Bpdy (Hector Perez-Rincon).

3.12 Hypochondriasis: Is There a Promising Treatment? (Tewfik K. Daradkeh).


Body Dysmorphic Disorder: A Reveiw (Guilio Perugi and Franco Frare).


4.1 The Complexity of Body Dysmorphic Disorder (Vilma Gabbay and Rachel G. Klein).

4.2 Preoccupation with Appearance: Limitations of Our Understanding and Treatment (Jon E. Grant).

4.3 Translational and Evolutional Models of Body Dysmorphic Disorder (Dan J. Stein).

4.4 Our Evolving Understanding of Body Dysmorphic Disorder (Nancy J. Keuthen and Antje Bohne).

4.5 Is Body Dysmorphic Disorder a Culturally Determined Expression of a Body Image Disorder? (David H. Gleaves and Suman Ambwani).

4.6 Body Dysmorphic Disorder: Awareness Needed (Don E. Jeffreys).

4.7 Recent Findings in Body Dysmorphic Disoder and Future Drections (Sabine Wilhelm and Ulrike Buhlmann).

4.8 Body Dysmorphic Disorder: Some Issues Conserning Classification and Treatment (Fugen Neziroglu).

4.9 Body Dysmorphic Disorder: The Antithesis of Narcissus (Andrew A. Nierenberg).

4.10 Playing the Devil's avocate: Is The Concept of Delusional Disorder, Somatic Type, Condemned to Extiction? (Leonardo F. Fontenelle, Mauro V. Mendlowicz and Marcio Versiani).

4.11 Advancing the Understanding of Dysmorphic Disorder (Eric Hollander and Bernardo Dell'Osso).

4.12 Is Body Dysmorphic Disorder More Than a DSM Construct? (Michel Botbol).

4.13 Body Dysmorphic Disorder and Obsessive-Compulsive Disorder: More Simularities than Differences (Euripedes C. Miguel, Albina R. Torres and Ygor A. Ferrao).


Chronic Fatigue and Neurasthenia: A Reveiw (Michael C. Sharpe and Simon Wessely).


5.1 From Neurasthenia to Chronic Fatigue Syndrome: A Journey, Not a Destination (Kurt Kroenke).

5.2 Tired People Challenge Medicine (Stefan Priebe).

5.3 Disease, Sickness or Illness: Which One Is Chronic Fatigue Syndrome and / or Neurasthenia? (Bedirhan Ustun).

5.4 Constructing Chronic Fatigue: Empiricism, Pyschiatry, and Sociocultural Contexts (Renee R. Taylor).

5.5 Chronic Fatigue Syndrome as a Paradigm for Pyschosomatic Medicine (James L. Levenson).

5.6 Beyond Fashion (Gordon Parker).

5.7 Chronic Fatigue and Disembodied DSM (Sing Lee and Arthur Kleinman).

5.8 Problems of Definition, Etiological Approaches and Issues of Management in Chronic Fatiguing Disorders (Anne Farmer and Tom Fowler).

5.9 Chronic Fatigue Syndrome: Time to Concentrate on Fatigue, Not Chronicity (Petros Skapinakis and Venetsanos Mavreas).

5.10 Chronic Fatigue Syndrome: A Real Disease, A Real Problem (Jonathan R. Price).

5.11 The Specificity of Chronic Fatigue, Neurasthenia, and Somatoform Disorders (Winfried Reif).

5.12 Chronic Fatigue in Developing Countries (Vikram Patel).

5.13 Functional Somatic Syndromes: Many Names for the Same Thing? (Marco Antonio Brasil, Jose Carlos Appolinario and Sandra Fortes).

5.14 Recent Developments in Chronic Fatigue Syndrome (Ruud C.W. Vermeulen).

5.15 Does Nuerasthenia Really Exist in this Century? (Edmond Chiu).


Factitious Physical Disorders: A Reveiw (Stuart J. Eisendrath and John Q. Young).


6.1 Wilful Deception as Illness Behavour (Christopher Bass).

6.2 Factitious Disorders: Diagnosis or Misbehavour/ (Charles V. Ford).

6.3 Factitious Disorder and Malingering: The Doctors Dilemma (Stephen M. Lawrie and Michael C. Sharpe).

6.4 Factitious Physical Disorders: The Challenges of Efficient Recognition and Effective Intervention (Lois E. Krahn).

6.5 Some Aspects of Factitious Physical Disorders by Proxy (Christopher Cordes).

6.6 Inventing Illness: The Deviant POatient (Don R. Lipsitt).

6.7 Characterizing Factitious Physical Symptoms (David G. Folks).

6.8 Moral Constraints, Regret, and Remorse in Treating Patients with Factitious Disorder (Ovidio A. De Leon).

6.9 Fact, Fiction, Factitious, or Fractious Disorders  (Dinesh Bhugra).

6.10 Factitious Physical Disorders: A Strategy of Survival for Medically Trained Traumatized Borderlines? (Ramon Florenzano).

6.11 Factitious Physical Disorders and Malingering: The Hazardous Link (Saida Douki, Sara Benzineb and Fathy Nacef).


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