Category: Somatic Symptom Disorders

Somatoform Disorders in Brief

The root word “soma” means body. Somatoform refers to emotional problems presenting as physical complaints. You are likely most familiar with this from the somatoform disorder called “conversion disorder” in which a traumatized individual suddenly goes blind…or deaf…or cannot swallow or has seizures in the absence of a medical reason for those symptoms. In those …

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Psychosomatic Part I

Psychosomatic refers to one or more psychological or behavioral factors that affect an individuals general medical condition. These psychological or behavioral factors may contribute to the development of a medical condition, they may exacerbate the condition or they may delay recovery from a medical condition. The diagnostic code for this is 316.0 Psychological Factor Affecting …

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The Hypochondriac

There is a way (an algorithm if you will) that can help you determine who will (and will not) return to work. It is not necessarily related to the type or severity of the injury. If the injured worker is asked “Will you ever be able to work again?” the following responses can be categorized: …

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Somatization

Should we expect depression in all patients with chronic pain? Perhaps not, but you should always test for it. Approximately one-quarter of all chronic pain patients develop a (mood) depressive disorder With early and effective intervention, the vast majority of them improve rapidly. However, many injured workers had legal, financial, marital, occupational, interpersonal, addictive, and …

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Psychosomatic Part II

I am reminded of the young man who lost the tip of one finger on his nondominant hand and decompensated. His puzzled surgeon referred him to me for an evaluation in which it was revealed that in his culture, as the eldest son, he would have to play a musical instrument to guide his father …

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relatedness

Relatedness

Relatedness to injury: There are far too many times that when treating an injured worker, I come upon serious health problems …
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injury

Injury

Injury: If a wealthy man were to win the Lottery, his spending behavior is unlikely to be significantly altered. He was already …
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tertiary

Tertiary

Gain: “The concept of secondary gain is a frequently addressed observation as to the benefits a patient receives from …
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