Psychosomatic disorders - Synonyms

[Bob]

I'd like to compile a brief list of synonyms for 'psychosomatic' illness that has been used to describe ME. And any similar terminology. I'm always forgetting the terminology that they use.


I believe that the current favoured terminology is "functional somatic syndrome", but it changes regularly.


Psychosomatic diagnoses - list of similar terminology (Alphabetical order):

Abnormal illness behaviour
Affective spectrum dysorder
Behavioural disorder
Bodily distress syndrome (BDS)
Chronic multi-symptom illness
Conversion disorder
False illness beliefs
Functional neurological deficit
Functional Neurological Disorder
Functional disorder
Functional somatic disorder
Functional somatic syndrome
Hypochondria / Hypochondriasis
Hysteria / Mass hysteria
Medically unexplained chronic multisymptom illness
Medically unexplained disorders
Medically unexplained physical symptoms (MUPS)
Medically unexplained symptoms (MUS)
Neurasthenia
Physical symptom disorder
Persistant Physical Symptoms
Persistent unexplained physical symptoms (PUPS)
Psychogenic illness / Mass psychogenic illness
Psychosomatic illness.
Somatic Symptom Disorder
Somatization disorder
Somatisation of mental illness/anxiety.
Somatoform disorder



Other terminology that has been inappropriately used to describe ME patients:

All in the mind
Factitious disorder
Malingering




Have I missed anything? Have I included any that shouldn't be in the list?
Many of them have a Wikipedia entry.



And here's Wessely and White's delightful paper on the subject of the "functional somatic syndrome":

There is only one functional somatic syndrome
The British Journal of Psychiatry (2004)185: 95-96
doi:10.1192/bjp.185.2.95
http://bjp.rcpsych.org/content/185/2/95.full

And (via Tom Kindlon's Twitter account) here's what UK medical students are currently being taught about functional disorders, including CFS, in the 8th edition (2012) of the Kumar & Clark textbook, "Clinical Medicine":
https://www.inkling.com/read/kumar-...ne-8th/chapter-23/functional-or-psychosomatic

 

[Enid]

I must point out they may be analysing their own problems - 1) in normal slightly confused adolescence thought one might aid - he confessed to having dreams about me - I took off. 2) Collapsed in Accident and Emergency 3 junior Docs brought one in to persuade me "all in your mind". Now no matter long delayed diagnosis of hypothyroidism (well you don't collapse for nothing) these people are an anathema.

 

[user9876]

Try Medically unexplained physical symptoms (MUPS) medically explained symptoms (MUS) or meducally unexplained disorders.

http://en.wikipedia.org/wiki/Medically_unexplained_physical_symptoms

 

[alex3619]

Neurasthenia, right after hysteria. Hysteria goes back to ancient Greece, but it was Charcot who really defined it in the nineteenth century. Neurasthenia was used not long after Charcot formalized the definition of hysteria. While definitions may have changed later, my reading of early hysteria and neurasthenia is they are basically the same thing, at least according to Freud ... but hysteria was primarily for women, and neurasthenia primarily for men. Later both were seen as occuring commonly in both sexes.

Mass hysteria. Not sure when ... was used in 1970 though that I know of.

If we add in all the weird names used for specific "psychosomatic" disorders, this could be a long list. I forget all those names though, they never really took off, just as the disorders they portrayed were later seen as physical.

Somatic Symptom Disorder? As of DSM5.

Some of these are also listed as a syndrome, not a disorder, I think.

 

[SickOfSickness]

About halfway down the page they have a bunch including "other neurotic disorders". https://en.wikipedia.org/wiki/ICD-10_Chapter_V:_Mental_and_behavioural_disorders

 

[alex3619]

About halfway down the page they have a bunch including "other neurotic disorders". https://en.wikipedia.org/wiki/ICD-10_Chapter_V:_Mental_and_behavioural_disorders

Yes, including a big one we missed: hypochondria.

 

[Hip]

Bob Not all the conditions on your list are synonyms.

I copied the following definitions from here:

Somatoform disorder is a category that encompasses all disorders that are characterized by physical complaints that cannot be explained by a medical diagnosis. Somatoform disorders include the following diagnoses:

1) Conversion Disorder - Neurological symptoms without a neurological explanation. This diagnosis is restricted to motor and sensory symptoms. Include Numbness, paralysis, seizure, blindness, etc. May be preceded by an acute stressor. Also cannot be part of a somatization disorder (see below).

2) Somatization disorder - A patient who consistently complains of a variety of physical symptoms without a physiological explanation. The DSM requires that the onset must be before age 30, that there is pain in at least 4 different parts of the body, 2 GI problems (not including pain), one sexual symptom, and one neurological symptom.

3) Hypochondriasis - Excessive preoccupation or worry about illness that persists even after evaluation by a physician is negative. Fears that minor symptoms are indicative of a serious condition.

4) Body Dysmorphic Disorder - Excessive concern and preoccupation with physical flaws - either imagined or extremely minor - that cause significant psychological distress (and cannot be accounted for by another disorder, such as anorexia nervosa)

5) Pain Disorder - chronic pain in one or more area that cannot be otherwise explained.

Note also that it says here that:

There seems to be a general agreement among experts that most of the current somatoform diagnostic categories of the DSM-IV and ICD-10 are abolished and somatization disorder, undifferentiated somatoform disorder, somatoform pain disorder and corresponding diagnoses on the ICD-10, including autonomic dysfunction and neurasthenia, are combined. Different names have been suggested, for example bodily distress disorder, physical symptoms disorder, and multiform somatoform disorder. The hypochondriasis diagnosis would be retained but the name changed to health anxiety disorder.

Here it says that:

Somatic symptoms not attributable to any known conventionally defined disease have been given various names such as medically unexplained (physical) symptoms, functional somatic (or physical) symptoms, idiopathic symptoms, and somatoform symptoms.

Here it says that:

Functional somatic syndromes are physical illnesses without any organic disease explanation and devoid of demonstrable structural lesion or biochemical change. Alternative modern descriptors are somatoform disorders and medically unexplained symptoms.

The following document is also informative:
Somatoform disorders – functional somatic syndromes – Bodily distress syndrome. Need for care and organisation of care in an international perspective.



In any case, I'd like to point out that the basic conceptual foundation of a somatoform disorder is unscientific: in science, you cannot define something in terms of it being inexplicable. To define a somatoform disorder as a set of symptoms that cannot be explained by a medical diagnosis or by a physiological mechanism is scientifically untenable. Just because you cannot find a physical explanation for a disease and its symptoms at present, that does not mean you give up looking, and throw a disease into the category of a somatoform disorder.

Only in religion can you define something in terms of it being inexplicable. I am not anti-relgion at all, but religion often has a tendency to ascribe all unexplained phenomena to God's will, rather than to search for rational, physical explanations. So if someone dies in a car crash in a very religious country, often the people there will say it was God's will, rather than look for the rational, physical explanations that underpin car crashes (explanations like say the lack of good road markings or the lack of proper training for drivers).

 

[Bob]

Thanks everyone. I've added the suggestions, in no particular order.

I haven't included more specific diagnoses, such as "Body Dysmorphic Disorder", because I was after over-arching terms that are fairly similar to "psychosomatic", rather than more specific descriptions or diagnoses.

 

[Bob]

A couple more similar terms that I've added to the list:

Functional neurological deficit
Functional disorder

 

[Bob]

My not-so-formal diagnosis? That's on the official paperwork - 'undiagnosed neurological condition'. (at least it sounds like it's a physical ailment - but totally ignores a lot of my standard CFS symptoms).

Hi Penny, I haven't added that to the list, because I can't see any info on the internet that suggests it's used in the same way as the other terms. Have you come across anything?

 

[PennyIA]

I think you're right. I had actually come in and deleted it before I saw your reply. I think the fact that it makes it seem like it's actually a physical condition even though the end result is still a suggestion of only offering antidepressants as treatment just played out in my frustration. And why I ended up replying.

 

[Bob]

I think you're right. I had actually come in and deleted it before I saw your reply. I think the fact that it makes it seem like it's actually a physical condition even though the end result is still a suggestion of only offering antidepressants as treatment just played out in my frustration. And why I ended up replying.

Thanks Penny. I see what you mean. It's a totally unhelpful diagnosis.

 

[alex3619]

If the list were to be disordered, hysteria is clearly the original disorder/definition.

These are all psychosomatic disorder names, but such names are not synonyms as Hip pointed out ... that is they are not synonyms for each other. In recent decades the number of disorders has proliferated, each with its own arbitrary definition, and DSM-5 has been rejected by the NIMH in favour of developing new objective categories, though as its aiming at developing such categories it has its own reasons.

To mention just one of the "old" names for specific issues, stress ulcers comes to mind. "Clearly" stress caused ulcers as no cause could be found (though such a cause was found in the nineteenth century in Germany) so it had to be all in the mind.

Which brings me to the stock phrase "All in the Mind" which I think should be added, though its not a formal category.

 

[biophile]

Although not a formal diagnosis, Alex does touch upon stock phrases and concepts such as "all in the mind". A similar one is a supposed "lack of psyche-soma differentiation" where someone fails to realize that their physical symptoms are arising from emotional problems not disease.

Others which come to mind are "attention seeking" and "trying to be difficult", the latter which could result in a diagnosis of Oppositional Defiant Disorder for children who refuse the swallow the biopsychosocial ideology on their symptoms. There are others, and Bob already mentioned general "behavioural disorder"(s), but this one is the first I thought of:

Some signs and symptoms that must be perpetuated for longer than 6 months and must be considered beyond normal child behavior to fit the diagnosis are: The child must exhibit 4 out of the 8 signs and symptoms listed below in order to meet the DSM-IV-TR diagnostic threshold for oppositional defiant disorder:

• Actively refuses to comply with majority's requests or consensus-supported rules

• Performs actions deliberately to annoy others

• Angry and resentful of others

• Argues often

• Blames others for his or her own mistakes

• Often loses temper

• Spiteful or seeks revenge

• Touchy or easily annoyed

Generally, these patterns of behavior will lead to problems at school and other social venues.

 

[Bob]

I realise that they are not all exactly synonyms, and that some of the terms have, or can have, slightly different meanings.
I first intended it to be a list of synonyms just for "functional somatic syndrome", and it became broader than I first intended it to be.
It's a handy reference list, but perhaps I could make another list for terms that actually are just synonyms for "functional somatic syndrome".
Does anyone happen to know which terms are more or less identical, or were precursors to "functional somatic syndrome"?

 

[Little Bluestem]

My favorite is physical symptom disorder. That could describe just about any illness or injury.
They are all synonyms for "the doctor doesn't have a clue" or maybe "the medical industry doesn't have a clue".

 

[vamah]

Although not a formal diagnosis, Alex does touch upon stock phrases and concepts such as "all in the mind". A similar one is a supposed "lack of psyche-soma differentiation" where someone fails to realize that their physical symptoms are arising from emotional problems not disease.

Others which come to mind are "attention seeking" and "trying to be difficult", the latter which could result in a diagnosis of Oppositional Defiant Disorder for children who refuse the swallow the biopsychosocial ideology on their symptoms. There are others, and Bob already mentioned general "behavioural disorder"(s), but this one is the first I thought of:

Huh. I didn't know there was a fancy diagnostic term for this. I always just call it "being a teenager."

 

[MeSci]

I realise that they are not all exactly synonyms, and that some of the terms have, or can have, slightly different meanings.
I first intended it to be a list of synonyms just for "functional somatic syndrome", and it became broader than I first intended it to be.
It's a handy reference list, but perhaps I could make another list for terms that actually are just synonyms for "functional somatic syndrome".
Does anyone happen to know which terms are more or less identical, or were precursors to "functional somatic syndrome"?

What a coincidence - I just posted a link to a page about this in another thread:

http://www.neurosymptoms.org/#/in-the-mind/4533053408

It includes 'Non-Organic' and 'Psychogenic', and the pdf that you can download from a link on the right also includes 'Abnormal illness behaviour' as well as definitions that relate to deliberate fabrication of symptoms.

It occurs to me that repeated redefinition serves a useful purpose for the psychoquacks, confusing people about what is being claimed, and presenting an ever-moving target for sceptics.

 

[alex3619]

Yes, MeSci, redefinition is at least in part because people wake up to what they are really saying, and they lose respect with patients. Also if you google search on one name, you don't see the complaints/issues/problems under the other names. Besides, new names gives a reason to sell new copies of the DSM. Its not the new names that protects them from criticism, its the continual redefinitions. I mean, someone showed their last definition was bogus, but the new one might not be!

 

[Bob]

Thanks MeSci.

What a coincidence - I just posted a link to a page about this in another thread:

http://www.neurosymptoms.org/#/in-the-mind/4533053408

It includes 'Non-Organic' and 'Psychogenic', and the pdf that you can download from a link on the right also includes 'Abnormal illness behaviour' as well as definitions that relate to deliberate fabrication of symptoms.

I've added 'psychogenic' to the list, as it seems similar, after a brief read of the definition.

But I believe that 'non-organic' can be used to identify emotional disorders, such as post-traumatic stress disorder, or developmental disorders that can stem, for example, from child abuse. I believe this is to distinguish such disorders from conditions such as brain damage, autism and schizophrenia, where there are measurable changes in brain structure which have 'organic' (i.e. biomedical) origins rather than emotional or developmental origins. (I'm not an expert, so I might have some of this wrong.)
So I'm not sure if it should be added.

And 'abnormal illness behaviour' seems to refer to a specific type of condition, unless I've misunderstood it, so I've not added that either.

It occurs to me that repeated redefinition serves a useful purpose for the psychoquacks, confusing people about what is being claimed, and presenting an ever-moving target for sceptics.

Yes, I think you're spot-on here. Once patients catch on to what their diagnosis means, the psychs quickly give it a new name.