Skip to main content
SpringerLink
Log in
Book cover

Neurology and Psychiatry of Women pp 47–67Cite as

Somatoform Disorders

  • Chapter
  • First Online:

  • 873 Accesses

Abstract

The diagnoses grouped under the heading “Somatoform Disorders” describe patients for whom concerns about their health and/or somatic symptoms cause significant psychologic distress and impair functioning. This chapter will discuss clinically useful perspectives on somatoform disorders. It will review the main somatoform disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, and discuss the influence of sex and gender on the formulation, diagnosis, and management of these conditions.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   79.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Carson A, Lehn A. Epidemiology. Handb Clin Neurol. 2016;139:47–60.

    Article  CAS  PubMed  Google Scholar 

  2. Steinbrecher N, Koerber S, Frieser D, Hiller W. The prevalence of medically unexplained symptoms in primary care. Psychosomatics. 2011;52:263–71.

    Article  PubMed  Google Scholar 

  3. Kisely S, Goldber D, Simon G. A comparison between somatic symptoms with and without clear organic cause: results of an international study. Psychol Med. 1997;27:1011–9.

    Article  CAS  PubMed  Google Scholar 

  4. Tomenson B, Essau C, Jacobi F, Ladwig KH, Leiknes KA, Liet R, Meinlschmidt G, McBeth J, Rosmalen J, Rief W, Sumathipala A, Creed F. Total somatic symptom score as a predictor of health outcome in somatic symptom disorders. Br J Psychiatry. 2013;203:373–80.

    Article  PubMed  Google Scholar 

  5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.

    Book  Google Scholar 

  6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed., text rev. Washington, DC: American Psychiatric Publishing; 2000.

    Google Scholar 

  7. Drossman DA, Hasler WL. Rome IV-functional GI disorders: disorders of gut-brain interaction. Gastroenterology. 2016;150:1257–61.

    Article  PubMed  Google Scholar 

  8. Claassen-van Dessel N, van der Wouden JC, Dekker J, van der Horst HE. Clinical value of DSM IV and DSM 5 criteria for diagnosing the most prevalent somatoform disorders in patients with medically unexplained symptoms (MUPS). J Psychosom Res. 2016;82:4–10.

    Article  PubMed  Google Scholar 

  9. Voigt K, Wollburg E, Wienmann N, Herzog A, Beyer B. Predictive validity and clinical utility of DSM-5 somatic symptom disorder-comparison with DSM-IV somatoform disorders and additional criteria for consideration. J Psychosom Res. 2012;73:345–50.

    Article  PubMed  Google Scholar 

  10. Patel P, Bercik P, Morgan DF, Bolino C, Pintos-Sanchez MI, Moayyedi P, et al. Irritable bowel syndrome is significantly associated with somatisation in 840 patients, which may drive bloating. Aliment Pharmacol Ther. 2015;41:449–58.

    Article  CAS  PubMed  Google Scholar 

  11. Chen IC, Lee M, Lin HH, Wu S, Chang K, Lin HY. Somatoform disorder as a predictor of interstitial cystitis/bladder pain syndrome: evidence from a nested case control study and a retrospective cohort study. Medicine. 2017;96:18.

    Google Scholar 

  12. Scarella TM, Laferton JA, Ahern DK, Fallon BA, Barsky A. The relationship of hypochondriasis to anxiety, depressive, and somatoform disorders. Psychosomatics. 2016;57(2):200–7.

    Article  PubMed  Google Scholar 

  13. Gracie DJ, Bercik P, Morgan DG, Bolino C, Pintos-Sanchez MI, Moayyed P, et al. No increase in prevalence of somatization in functional vs organic dyspepsia: a cross-sectional study. Neurogastroenterol Motil. 2015;27:1024–31.

    Article  CAS  PubMed  Google Scholar 

  14. Ramond-Roquin A, Pecquenard F, Schers H, van Weel C, Oskam S, van Boven K. Psychosocial, musculoskeletal and somatoform comorbidity in patients with chronic low back pain: original results from the Dutch Transition Project. Fam Pract. 2015;32(3):297–304.

    Article  PubMed  Google Scholar 

  15. Rief W, Hiller W, Margraf J. Cognitive aspects of hypochondriasis and the somatization syndrome. J Abnorm Psychol. 1998;107(4):587–95.

    Article  CAS  PubMed  Google Scholar 

  16. Frostholm L, Ornbol E, Fink PK. Physical symptoms attributions: a defining characteristic of somatoform disorders? Gen Hosp Psychiatry. 2015;37:147–52.

    Article  PubMed  Google Scholar 

  17. Barsky AJ, Goodson JS, Lane RS, Cleary PD. The amplification of somatosensory symptoms. Psychosom Med. 1988;50:510–9.

    Article  CAS  PubMed  Google Scholar 

  18. Perez DL, Barsky AJ, Vago DR, Baslet G, Silbersweig DA. A neural circuit framework for somatosensory amplification in somatoform disorders. J Neuropsychiatr Clin Neurosci. 2015;27:e40–50.

    Article  Google Scholar 

  19. Kleiman A, Kramer KA, Wegener I, Kock AS, Geiser F, Imbierowicz K, et al. Psychological decoupling in alexithymic pain disorder patients. Psychiatry Res. 2016;237:316–22.

    Article  PubMed  Google Scholar 

  20. Barksy AJ, Orav J, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical co-morbidity. Arch Gen Psychiatry. 2005;62:903–10.

    Article  Google Scholar 

  21. De Waal MWM, Arnold IA, Eekhoff JAH, van Hemert AM. Somatoform disorders in general practice: prevalence, functional impairment, and co-morbidity with anxiety and depressive disorders. Br J Psychiatry. 2004;184:470–6.

    Article  PubMed  Google Scholar 

  22. Haller H, Cramer H, Lauche R, Dobos G. Somatoform disorders and medically unexplained symptoms in primary care- a systematic review and meta-analysis of prevalence. Dtsh Arztebl Int. 2015;112:279–87.

    Google Scholar 

  23. Fink P, Hansen MS, Oxhoj ML. The prevalence of somatoform disorders among internal medicine inpatients. J Psychosom Res. 2004;56:413–8.

    Article  PubMed  Google Scholar 

  24. Fink P, Hansen MS, Sondergaard L. Somatoform disorders among first-time referrals to a neurology service. Psychosomatics. 2005;46(6):540–8.

    Article  PubMed  Google Scholar 

  25. Obimakinde AM, Ladipo MM, Irabor AE. Familial and socio-economic correlates of somatisation disorder. Afr J Prim Health Care Fam Med. 2015;7(1):746.

    Article  PubMed Central  Google Scholar 

  26. Swartz M, Landerman R, Blazer D, George L. Somatization in the community: a rural/urban comparison. Psychosomatics. 1989;30:44–53.

    Article  CAS  PubMed  Google Scholar 

  27. Barsky AJ, Peekna HM, Borus J. Somatic symptom reporting in women and men. J Gen Intern Med. 2001;16:266–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Jackson JL, Kroenke K. Prevalence, impact, and prognosis of multisomatoform disorder in primary care: a 5-year follow-up study. Psychosom Med. 2008;70(4):430–4.

    Article  PubMed  Google Scholar 

  29. Hansen HS, Rosendal M, Oernboel E, Fink P. Are medically unexplained symptoms and functional disorders predictive for the illness course? A two-year follow-up on patients’ health and health care utilization. J Psychosom Res. 2011;71:38–44.

    Article  PubMed  Google Scholar 

  30. McAndrew LM, Phillips IA, Helmer DA, Maestro K, Engel CC, Greenberg LM, et al. High healthcare utilization near the onset of medically unexplained symptoms. J Psychosom Res. 2017;98:98–105.

    Article  PubMed  Google Scholar 

  31. Lee S, Creed FH, Ma Y, Leung CMC. Somatic symptom burden and health anxiety in the population and their correlates. J Psychosom Res. 2015;78:71–6.

    Article  PubMed  Google Scholar 

  32. Rask MT, Rosendal M, Fenger-Gron M, Bro F, Ornbol E, Fink P. Sick leave and work disability in primary care patients with recent onset multiple medically unexplained symptoms and persistent somatoform disorders: a 10-year follow-up of the FIP study. Gen Hosp Psychiatry. 2015;37:53–9.

    Article  PubMed  Google Scholar 

  33. Silverstein B. Gender differences in the prevalence of somatic versus pure depression: a replication. Am J Psychiatry. 2002;159:1051–2.

    Article  PubMed  Google Scholar 

  34. Clarke DM, Piterman L, Byrne CJ, Austin DW. Somatic symptoms, hypochondriasis and psychological distress: a study of somatisation in Australian general practice. Med J Aust. 2008;189(10):560–4.

    PubMed  Google Scholar 

  35. Escobar JI, Burnam A, Karno M, Forsythe A, Golding JM. Somatization in the community. Arch Gen Psychiatry. 1987;44:713–8.

    Article  CAS  PubMed  Google Scholar 

  36. Berna C, Leknes S, Holmes EA, Edwins RR, Goodwin GM, Tracey I. Induction of depressed mood disrupts emotion regulation neurocircuitry and enhances pain unpleasantness. Biol Psychiatry. 2010;67:1083–90.

    Article  PubMed  Google Scholar 

  37. Coen SJ, Yaguez L, Aziz Q, Mitterschiffthaler MT, Brammer M, Williams SC, et al. Negative mood affects brain processing of visceral sensation. Gatroenterology. 2009;137:253–61.

    Article  Google Scholar 

  38. Ploner M, Lee MC, Wiech K, Bingel U, Tracey I. Prestimulus functional connectivity determines pain perception in humans. Proc Natl Acad Sci U S A. 2010;107:355–60.

    Article  PubMed  Google Scholar 

  39. Wagner G, Koschke M, Leuf T, Schlosser R, Bar KJ. Reduced heat pain threshold after sad-mood induction are associated with changes in thalamic activity. Neuropsychologia. 2009;47:980–7.

    Article  PubMed  Google Scholar 

  40. Dijkstra-Kersten SMA, Sitnikova K, van Marwijk HMWJ, Gerrits MMJG, van der Wouden JC, Penninx BWJH, et al. Somatisation as a risk factor for incident depression and anxiety. J Psychosom Res. 2015;79:614–9.

    Article  PubMed  Google Scholar 

  41. Den Boeft M, Claasseen-van Dessel N, van der Wouden JC. How should we manage adults with persistent unexplained physical symptoms? BMJ. 2017;256:j268.

    Article  Google Scholar 

  42. Kroenke K, Messina N, Benattia I, Graepel J, Musgnung J. Venlafaxine extended release in the short-term treatment of depressed and anxious primary care patients with multisomatoform disorder. J Clin Psychiatry. 2006;67(1):72–80.

    Article  CAS  PubMed  Google Scholar 

  43. Luo YL, Zhang MY, Wu WY, Li CB, Lu Z, Li QW. A randomized double-blind clinical trial on analgesic efficacy of fluoxetine for persistent somatoform pain disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(8):1522–5.

    Article  CAS  PubMed  Google Scholar 

  44. Müller JE, Wentzel I, Koen L, Niehaus DJ, Seedat S, Stein DJ. Escitalopram in the treatment of multisomatoform disorder: a double-blind, placebo-controlled trial. Int Clin Psychopharmacol. 2008;23(1):43–8.

    Article  PubMed  Google Scholar 

  45. Huang M, Luo B, Hu J, Wei N, Chen L, Wang S, et al. Combination of citalopram plus paliperidone is better than citalopram alone in the treatment of somatoform disorder: results of a 6-week randomized study. Int Clin Psychopharmacol. 2012;27(3):151–8.

    Article  PubMed  Google Scholar 

  46. Li G, Jin W. Comparison study of paroxetine and paroxetine combined with quetiapine in treatment of somatoform disorder. Chin J Behav Med Sci. 2006;15(7):598–9.

    Google Scholar 

  47. Kleinstäuber M, Witthöft M, Steffanowski A, van Marwijk H, Hiller W, Lambert MJ. Pharmacological interventions for somatoform disorders in adults. Cochrane Database Syst Rev. 2014;(11):CD010628.

    Google Scholar 

  48. Müller T, Mannel M, Murck H, Rahlfs VW. Treatment of somatoform disorders with St. John’s wort: a randomized, double-blind and placebo-controlled trial. Psychosom Med. 2004;66(4):538–47.

    Article  PubMed  Google Scholar 

  49. Volz HP, Murck H, Kasper S, Möller HJ. St John’s wort extract (li 160) in somatoform disorders: results of a placebo-controlled trial [Johanniskrautextrakt (LI 160) bei somatoformen Stoerungen: Ergebnisse einer plazebokontrollierten Studie]. Psychopharmacology. 2002;164(3):294–300.

    Article  CAS  PubMed  Google Scholar 

  50. van Dessel N, den Boeft M, van der Wouden JC, Kleinstauber M, Leone SS, Terluin B, et al. Non-pharmacological interventions for somatoform disorders and medically unexplained physical symptoms (MUPS) in adults. Cochrane Database Syst Rev. 2014;(11):CD011142.

    Google Scholar 

  51. Allen LA, Woolfolk RL, Escobar JI, Gara MA, Hamer RM. Cognitive-behavioral therapy for somatization disorder: a randomized controlled trial. Arch Intern Med. 2006;166:1512–8.

    Article  PubMed  Google Scholar 

  52. Burton C, Weller D, Marsden W, Worth A, Sharpe M. A primary care symptoms clinic for patients with medically unexplained symptoms: pilot randomised trial. BMJ Open. 2012;2:e000513.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Escobar JI, Gara MA, Diaz-Martinez AM, Interian A, Warman M, Allen LA, et al. Effectiveness of a time-limited cognitive behavior therapy type intervention among primary care patients with medically unexplained symptoms. Ann Fam Med. 2007;5:328–35.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Kashner TM, Rost K, Cohen B, Anderson M, Smith GR Jr. Enhancing the health of somatization disorder patients. Effectiveness of short-term group therapy. Psychosomatics. 1995;36:462–70.

    Article  CAS  PubMed  Google Scholar 

  55. Martin A, Rauh E, Fichter M, Rief W. A one-session treatment for patients suffering from medically unexplained symptoms in primary care: a randomized clinical trial. Psychosomatics. 2007;48:294–303.

    Article  PubMed  Google Scholar 

  56. Moreno S, Gili M, Magallón R, Bauzá N, Roca M, Del Hoyo YL, et al. Effectiveness of group versus individual cognitive-behavioral therapy in patients with abridged somatization disorder: a randomized controlled trial. Psychosom Med. 2013;75:600–8.

    Article  CAS  PubMed  Google Scholar 

  57. Schweickhardt A, Larisch A, Wirsching M, Fritzsche K. Short-term psychotherapeutic interventions for somatizing patients in the general hospital: a randomized controlled study. Psychother Psychosom. 2007;76:339–46.

    Article  PubMed  Google Scholar 

  58. Sumathipala A, Hewege S, Hanwella R, Mann AH. Randomized controlled trial of cognitive behaviour therapy for repeated consultations for medically unexplained complaints: a feasibility study in Sri Lanka. Psychol Med. 2000;30:747–57.

    Article  CAS  PubMed  Google Scholar 

  59. Lidbeck J. Group therapy for somatization disorders in primary care: maintenance of treatment goals of short cognitive-behavioural treatment one-and-a-half-year follow-up. Acta Psychiatr Scand. 2003;107:449–56.

    Article  CAS  PubMed  Google Scholar 

  60. Magallón R, Gili M, Moreno S, Bauzá N, García-Campayo J, Roca M, et al. Cognitive-behaviour therapy for patients with abridged somatization disorder (SSI 4,6) in primary care: a randomized, controlled study. BMC Psychiatry. 2008;8:47.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Zonneveld LN, van Rood YR, Kooiman CG, Timman R, van’t Spijker A, Busschbach JJ. Predicting the outcome of a cognitive-behavioral group training for patients with unexplained physical symptoms: a one-year follow-up study. BMC Public Health. 2012;12:848.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Zonneveld LN, van Rood YR, Timman R, Kooiman CG, Van’t Spijker A, Busschbach JJ. Effective group training for patients with unexplained physical symptoms: a randomized controlled trial with a non-randomized one year follow-up. PLoS One. 2012;7:e42629.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Katsamanis M, Lehrer PM, Escobar JI, Gara MA, Kotay A, Liu R. Psychophysiologic treatment for patients with medically unexplained symptoms: a randomized controlled trial. Psychosomatics. 2011;52:218–29.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Chowdhury S, Burton C. Associations of treatment effects between follow-up times and between outcome domains in interventions for somatoform disorders: review of three Cochrane reviews. J Psychosom Res. 2017;98:10–8.

    Article  PubMed  Google Scholar 

  65. Fjorback LO, Arendt M, Ornbol E, Walach H, Rehfeld E, Schroder A, et al. Mindfulness therapy for somatization disorder and functional somatic syndromes-randomized trial with one year follow-up. J Psychosom Res. 2013;74(1):31–40.

    Article  PubMed  Google Scholar 

  66. Van Ravesteijn H, Lucassen P, Bor H, van Weel C, Speckens A. Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: a randomized controlled trial. Psychother Psychosom. 2013;82:299–310.

    Article  PubMed  Google Scholar 

  67. Sattel H, Lahmann C, Gunder H, Guthrie E, Kruse J, Noll-Hussong M, et al. Brief psychodynamic interpersonal psychotherapy for patients with multisomatoform disorder: randomized controlled trial. Br J Psychiatry. 2012;200(1):60–7.

    Article  CAS  PubMed  Google Scholar 

  68. Chavooshi B, Mohammadkhani P, Dolatshahi B. A randomize double-blind controlled trial comparing Davanloo intensive short-term dynamic psychotherapy as internet delivered vs. treatment as usual for medically unexplained pain: a 6-month pilot study. Psychosomatics. 2016;57(3):292–300.

    Article  PubMed  Google Scholar 

  69. Schaefert R, Kaufmann C, Wild B, Schellberg D, Boelter R, Faber R, et al. Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: a cluster randomized controlled trial. Psychother Psychosom. 2013;82:106–19.

    Article  CAS  PubMed  Google Scholar 

  70. Aiarzaguena JM, Grandes G, Gaminde I, Salazar A, Sanchez A, Arino J. A randomized controlled clinical trial of a psychosocial and communication intervention carried out by GPs for patients with medically unexplained symptoms. Psychol Med. 2007;37:283–94.

    Article  PubMed  Google Scholar 

  71. Larisch A, Schweickhardt A, Wirsching M, Fritzsche K. Psychosocial interventions for somatizing patients by the general practitioner: a randomized controlled trial. J Psychosom Res. 2004;57:507–14.

    Article  PubMed  Google Scholar 

  72. Morriss RK, Gask L, Ronalds C, Thompson H, Goldberg D. Clinical and patient satisfaction outcomes of a new treatment for somatized mental disorder taught to general practitioners. Br J Gen Pract. 1999;49:263–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  73. Rosendal M, Olesen F, Fink P, Toft T, Sokolowski I, Bro F. A randomized trial of brief training in the assessment and treatment of somatization in primary care: effects on patient outcome. Gen Hosp Psychiatry. 2007;29(4):364–73.

    Article  PubMed  Google Scholar 

  74. Shaefert R, Kaufmann C, Wild B, Schellberg D, Boelter R, Faber R, et al. Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: a cluster randomized controlled trial. Psychother Psychosom. 2013;82(2):106–19.

    Article  Google Scholar 

  75. Toft T, Rosendal M, Ornbol E, Olesen F, Frostholm L, Fink P. Training general practitioners in the treatment of functional somatic symptoms: effects on patient health in a cluster-randomised controlled trial (the Functional Illness in Primary Care study). Psychother Psychosom. 2010;79(4):227–37.

    Article  PubMed  Google Scholar 

  76. Frostholm L, Fink P, Oernboeel E, Christensen KS, Toft T, Olesen F, et al. The uncertain consultation and patient satisfaction: the impact of patients’ illness perceptions and a randomized controlled trial on the training of physicians’ communication skills. Psychosom Med. 2005;67(6):897–905.

    Article  PubMed  Google Scholar 

  77. Rosendal M, Bro F, Sokolowski I, Fink P, Toft T, Olesen F. A randomized controlled trial of brief training in assessment and treatment of somatisation: effects on GP’s attitudes. Fam Pract. 2005;22(4):419–27.

    Article  PubMed  Google Scholar 

  78. Dickinson WP, Dickinson LM, DeGruy FV, Main DS, Candib LM, Rost K. A randomized clinical trial of a care recommendation letter intervention for somatization in primary care. Ann Fam Med. 2003;1:228–35.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Rost K, Kashner TM, Smith GR. Effectiveness of psychiatric intervention with somatization disorder patients: improved outcomes at reduced costs. Gen Hosp Psychiatry. 1994;16:381–7.

    Article  CAS  PubMed  Google Scholar 

  80. Smith GR, Monson RA, Ray DC. Psychiatric consultation in somatization disorder. N Engl J Med. 1986;314:1407–13.

    Article  PubMed  Google Scholar 

  81. Smith GR, Rost K, Kashner M. A trial of the effect of a standardized psychiatric consultation on health outcomes and costs in somatizing patients. Arch Gen Psychiatry. 1995;52:238–43.

    Article  PubMed  Google Scholar 

  82. van der Feltz-Cornelis CM, van Oppen P, Ader HJ, van Dyck R. Randomised controlled trial of a collaborative care model with psychiatric consultation for persistent medically unexplained symptoms in general practice. Psychother Psychosom. 2006;75(5):282–9.

    Article  PubMed  Google Scholar 

  83. Van der Feltz-Cornelis CM, Van Os TWDP, van Marwijk HWJ, Leentjens AFG. Effect of psychiatric consultation models in primary care. A systematic review and meta-analysis of randomized controlled trials. J Psychosom Res. 2010;68:521–33.

    Article  PubMed  Google Scholar 

  84. Schutte K, Vocks S, Waldorf M. Fears, coping styles, and health behaviors: a comparison of patients with hypochondriasis, panic disorder, and depression. J Nerv Ment Dis. 2016;204:778–86.

    Article  PubMed  Google Scholar 

  85. Barsky A, Wyshak G, Klerman G. Hypochondriasis: an evaluation of the DSM-III criteria in medical outpatients. Arch Gen Psychaitry. 1986;43(5):493–500.

    Article  CAS  Google Scholar 

  86. Speckens AEM, Spinhoven P, Slockers PPA, Bolk JH, van Helmert AM. A validation of the whitely index, the illness attitude scales, and the somatosensory amplification scale in general medical and general practice patients. J Psychosom Res. 1996;40:95–104.

    Article  CAS  PubMed  Google Scholar 

  87. Pilowsky I. Dimensions of hypochondriasis. Br J Psychiatry. 1967;113:89–93.

    Article  CAS  PubMed  Google Scholar 

  88. Pilowsky I. A general classification of abnormal illness behaviours. Br J Med Psychol. 1978;51:131–7.

    Article  CAS  PubMed  Google Scholar 

  89. Barsky AJ, Ahern DK, Bailey ED, Saintfort R, Liu EB, Peekna HM. Hypochondriacal patients’ appraisal of health and physical risks. Am J Psychiatry. 2001;158:783–7.

    Article  CAS  PubMed  Google Scholar 

  90. Hadjistavropoulos HD, Craig KD, Hajistavropoulos T. Cognitive and behavioural responses to illness information: the role of health anxiety. Behav Res Ther. 1998;36:149–64.

    Article  CAS  PubMed  Google Scholar 

  91. Schwind J, Nenh JMB. Changes in free symptom attributions in hypochondriasis after cognitive therapy and behavioral therapy. Behav Cogn Psychother. 2016;44(5):601–14.

    Article  PubMed  Google Scholar 

  92. Wells A, Hackmann A. Imagery and core beliefs in health anxiety: contents and origins. Behav Cogn Psychother. 1993;21:265–73.

    Article  Google Scholar 

  93. Barksy AJ, Coueytaux RR, Sarnie MK, Cleary PD. Hypochondriacal patients’ beliefs about good health. Am J Psychiatry. 1993;150:1085–9.

    Article  Google Scholar 

  94. Abramovitz J, Olantuji B, Deacon B. Health anxiety, hypochondriasis, and the anxiety disorders. Behav Ther. 2007;38:86–94.

    Article  Google Scholar 

  95. van den Heuvel OA, Veltman DJ, Groenewegen HJ, Witter MP, Merkelbach J, Cath DC, et al. Disorder-specific neuroanatomincal correlates of attentional bias in obsessive-compulsive disorder, panic disorder, and hypochondriasis. Arch Gen Psychiatry. 2005;62:922–33.

    Article  PubMed  Google Scholar 

  96. van den Heuvel OA, Mataix-Cols D, Zwister G, Cath DC, ven der Werf YD, Groenewegen HJ, et al. Common limbic and frontal-striatal disturbances in patients with obsessive-compulsive disorder, panic disorder, and hypochondriasis. Psychol Med. 2011;41(11):2399–410.

    Article  PubMed  Google Scholar 

  97. Newby JM, Hobbs MJ, Mahoney AEJ, Wong S, Andrews G. DSM-5 illness anxiety disorder and somatic symptom disorder: comorbidity, correlates, and overlap with DSM-IV hypochondriasis. J Psychosom Res. 2017;101:31–7.

    Article  PubMed  Google Scholar 

  98. Thorgaard MV, Frostholm L, Walker LS, Stengaard-Pedersen K, Karlsson MM, Jensen JS, Fink P, Rask CU. Effects of maternal health anxiety on children’s health complaints, emotional symptoms, and quality of life. Eur Child Adolesc Psychiatry. 2017;26:591–601.

    Article  PubMed  Google Scholar 

  99. Barsky A. Hypochondriasis and obsessive-compulsive disorder. Psychiatr Clin N Am. 1992;15(4):791–801.

    Article  CAS  Google Scholar 

  100. Fallon B, Qureshi A, Schneider F, Sanchez-Lacay A, Vermes D, Reinstein R, et al. An open trial of fluvoxamine for hypochondriasis. Psychosomatics. 2003;44:298–303.

    Article  CAS  PubMed  Google Scholar 

  101. Greeven A, van Balkom A, Visser S, Merkelbach J, van Rood Y, van Dyck R, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. Am J Psychiatry. 2007;164:91–9.

    Article  PubMed  Google Scholar 

  102. Hiller W, Leibbrand R, Rief W, Fichter MM. Differentiating hypochondriasis from panic disorder. J Anxiety Disord. 2005;19(1):29–49.

    Article  PubMed  Google Scholar 

  103. Noyes R, Kathol RG, Fisher MM, Phillips BM, Suelzer MT, Woodman CL. Psychiatric co-morbidity among patient with hypochondriasis. Gen Hosp Psychiatry. 1994;16:78–87.

    Article  PubMed  Google Scholar 

  104. Barsky A, Wyshak G, Klerman GL, Latham S. The prevalence of hypochondriasis in medical outpatients. Soc Psychiatry Psychiatr Epidemiol. 1990;25(2):89–94.

    CAS  PubMed  Google Scholar 

  105. Kirmayer LJ, Robbins JM. Three forms of somatization in primary care: prevalence, co-occurrence, and sociodemographic characteristics. J Nerv Ment Dis. 1991;179:647–55.

    Article  CAS  PubMed  Google Scholar 

  106. Noyes RJ, Kathol RG, Fisher MM, Philips BM, Suelzer MT, Holt CS. The validity of DSM III hypochondriasis. Arch Gen Psychiatry. 1993;50(12):961–70.

    Article  PubMed  Google Scholar 

  107. Spitzer RL, Williams JB, Kroenke K, Linzer M, deGruy FV, Hahn SR, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. 1994;272:1749–56.

    Article  CAS  PubMed  Google Scholar 

  108. Sunderland M, Newby JM, Andrews G. Health anxiety in Australia: prevalence, comorbidity, disability and service use. Br J Psychiatry. 2013;202:56–61.

    Article  PubMed  Google Scholar 

  109. Weck F, Richtberg S, Neng J. Epidemiology of hypochondriasis and health anxiety: comparison of different diagnostic criteria. Curr Psychiatr Rev. 2014;10:14–23.

    Article  Google Scholar 

  110. Seivewright H, Mulder R, Tyrer P. Prevalence of health anxiety and medically unexplained symptoms in general practice and hospital clinics. Aust N Z J Psychiatry. 2007;41(suppl2):A159.

    Google Scholar 

  111. Tyrer P, Cooper S, Crawford M, Dupont S, Green J, Murphy D, et al. Prevalence of health anxiety problems in medical clinics. J Psychosom Res. 2011;71:392–4.

    Article  PubMed  Google Scholar 

  112. Bleichhardt G, Hiller W. Krankheitsangst bei Patienten in ambulanter Verhaltenstherapie: Psychopathologie, medizinische Inanspruchnahme und Mediennutzung [Pathological features, medical consulting behaviour and media consume in outpatients with health anxiety]. Verhaltenshtherapie Verhaltensmedizin. 2006;27:29–41.

    Google Scholar 

  113. Garyfallos G, Adamopoulou A, Karastergiou A, Voikli M, Ikonomidis N, Donias S, et al. Somatoform disorders: comorbidity with other DSM-III-R psychiatric diagnosis in Greece. Compr Psychiatry. 1999;40:299–307.

    Article  CAS  PubMed  Google Scholar 

  114. Pieh C, Lahmann C, von Heymann F, Tritt K, Loew T, Busch V, et al. Prävalenz und Komorbidität der somatoformen Störung: Eine Multicenter-Studie [Prevalence and comorbidity of somatoform disorder in psychosomatic inpatients: a multicentre study]. Z Psychosom Med Psychother. 2011;57:244–50.

    PubMed  Google Scholar 

  115. Weck F, Harms G, Neng J, Stangier U. Hypochondrische Merkmale bei Patienten einer psychotherapeutischen Ambulanz: Prävalenz und prädisponierende Faktoren [Hypochondriacal characteristics in psychotherapeutic outpatients: prevalence and predisposing factors]. Z Klin Psychol Psychother. 2011;40:124–32.

    Article  Google Scholar 

  116. Creed F, Barsky A. A systematic review of the epidemiology of somatization disorder and hypochondriasis. J Psychosom Res. 2004;56(4):391–408.

    Article  PubMed  Google Scholar 

  117. Jacobi F, Wittchen HU, Holting C, Hofler M, Pfister H, Muller N, et al. Prevalence, co-morbidity, and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med. 2004;34:597–611.

    Article  CAS  PubMed  Google Scholar 

  118. Barsky AJ, Fama JM, Bailey D, Ahern DKA. Prospective 4- to 5-year study of DSM-III-R hypochondriasis. Arch Gen Psychiatry. 1998;55:737–44.

    Article  CAS  PubMed  Google Scholar 

  119. Gropalis M, Bleichhardt G, Witthoft M, Hiller W. Hypochondriasis, somatoform disorders, and anxiety disorders: sociodemographic variables, general psychopathology, and naturalistic treatment effects. J Nerv Ment Dis. 2012;200:406–12.

    Article  PubMed  Google Scholar 

  120. Fink P, Ørnbøl E, Christensen KS. The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health. PLoS One. 2010;5(3):e9873.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  121. Hedman E, Lekander M, Ljotsson B, Lindefors N, Ruck C, Andersson G, et al.. 2015Optimal cut-off points on the health anxiety inventory, illness attitude scales, and whitely index to identify severe health anxiety. PLoS One. 2015;10(4):e0123412.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  122. Palsson N. Functional somatic symptoms and hypochondriasis among general practice patients: a pilot study. Acta Psychiatr Scand. 1998;78:191–7.

    Article  Google Scholar 

  123. Bobevski I, Clarke DM, Meadows G. Health anxiety and its relationship to disability and service use: findings from a large epidemiological survey. Psychosom Med. 2015;78:13–25.

    Article  Google Scholar 

  124. Eilenberg T, Frostholm L, Schroder A, Jensen JS, Fink P. Long-term consequences of severe health anxiety on sick leave in treated and untreated patients: analysis alongside a randomised controlled trial. J Anxiety Disord. 2015;32:95–102.

    Article  PubMed  Google Scholar 

  125. Gureje O, Ustun TB, Simon GE. The syndrome of hypochondriasis: a cross-national study in primary care. Psychol Med. 1997;27(5):1001–10.

    Article  CAS  PubMed  Google Scholar 

  126. Martin A, Jacobi F. Features of hypochondriasis and illness worry in the general population in Germany. Psychosom Med. 2006;68(5):770–7.

    Article  PubMed  Google Scholar 

  127. Mykletun A, Heradstveit O, Eriksen K, Glozier N, Overland S, Maeland JG, et al. Health anxiety and disability pension award: the HUSK Study. Psychosom Med. 2009;71(3):353–60.

    Article  PubMed  Google Scholar 

  128. Barsky AJ, Cleary PD, Sarnie MK, Klerman GL. The course of transient hypochondriasis. Am J Psychiatry. 1993;150:484–8.

    Article  CAS  PubMed  Google Scholar 

  129. Barsky AJ, Bailey ED, Fama JM, Ahern DK. Predictors of remission in DSM hypochondriasis. Compr Psychiatry. 2000;41:179–83.

    Article  CAS  PubMed  Google Scholar 

  130. Fernandez C, Fernandez R, Isaac Amigo D. Characteristics and one year follow-up of primary care patients with health anxiety. Prim Care Community Psychiatry. 2005;10:81–93.

    Article  Google Scholar 

  131. Noyes R, Kathol RG, Fisher MM, Phillips BM, Suelzer MT, Woodman CL. One-year follow-up of medical outpatients with hypochondriasis. Psychosomatics. 1994;35(6):533–45.

    Article  PubMed  Google Scholar 

  132. Olde-Hartman TC, Borghuis MS, Lucassen PLBJ, van de Laar FA, Speckens AE, van Weel C. Medically unexplained symptoms, somatisation disorder, and hypochondriasis: course and prognosis. A systematic review. J Psychosom Res. 2009;66:363–77.

    Article  PubMed  Google Scholar 

  133. Simon GE, Gureje O, Fullerton C. Course of hypochondriasis in an international primary care study. Gen Hosp Psychiatry. 2001;23:51–5.

    Article  CAS  PubMed  Google Scholar 

  134. Fallon B, Liebowitz M, Salman E. Fluoxetine for patients without major depression. J Clin Psychopharmacol. 1993;13:438–41.

    Article  CAS  PubMed  Google Scholar 

  135. Fallon B, Petkova E, Skritskaya N. A double-masked placebo controlled study of fluoxetine for hypochondriasis. J Clin Psychopharmacol. 2008;28:638–45.

    Article  CAS  PubMed  Google Scholar 

  136. Fallon BA, Ahern DK, Pavlicova M, Slavov I, Skritskya N, Barsky AJ. A randomized controlled trial of medication and cognitive behavioral therapy for hypochondriasis. Am J Psychiatry. 2017;174(8):756–64.

    Article  PubMed  PubMed Central  Google Scholar 

  137. Oosterbaan D, van Balkom A, van Boeijen C, de Meij T, van Dyck R. An open study of paroxetine in hypochondriasis. Prog Neuropsychopharmacol Biol Psychiatry. 2001;25:1023–33.

    Article  CAS  PubMed  Google Scholar 

  138. Greeven A, van Balkom A, van der Leeden R, Merkelbach J, van daen Heuvel O, Spinhoven P. Cognitive behavioral therapy versus paroxetine in the treatment of hypochondriasis: an 18-month naturalistic follow-up. J Behav Ther Exp Psychother. 2009;40(3):487–96.

    Article  Google Scholar 

  139. Bouman TK, Visser S. Cognitive and behavioural treatment of hypochondriasis. Psychother Psychosom. 1998;67:214–21.

    Article  CAS  PubMed  Google Scholar 

  140. Bourgault-Fagnou MD, Hadjistavropoulos HD. A randomized trial of two forms of cognitive behaviour therapy for an older adult population with subclinical health anxiety. Cogn Behav Ther. 2013;42:31–44.

    Article  PubMed  Google Scholar 

  141. Clark DM, Salkovsis PM, Hackmann A, Wells A, Fennell M, Ludgate J, et al. Two psychological treatments for hypochondriasis: a randomized controlled trial. Br J Psychiatry. 1998;173:218–25.

    Article  CAS  PubMed  Google Scholar 

  142. Eilenberg T, Frostholm L, Schroder A, Jensen JS, Fink P. Long-term consequences of severe health anxiety on sick leave in treated and untreated patients: analysis alongside a randomized control trial. J Anxiety Disord. 2015;32:95–102.

    Article  PubMed  Google Scholar 

  143. Olantuji B, Kauffman BY, Meltzer S, Davis ML, Smits JA, Powers MB. Cognitive-behavioral therapy for hypochondriasis/health anxiety: a meta-analysis of treatment outcome and moderators. Behav Res Ther. 2014;58:65–74.

    Article  Google Scholar 

  144. Sanatinia R, Wang D, Tyrer P, Tyrer H, Crawford M, Cooper S, et al. Impact of personality status on the outcomes and cost of cognitive behavioural therapy for health anxiety. Br J Psychiatry. 2016;209(3):244–50.

    Article  PubMed  PubMed Central  Google Scholar 

  145. Salkovskis PM, Warwick HM, Deale AC. Cognitive-behavioral treatment for severe and persistent health anxiety (hypochondriasis). Brief Treat Crisis Interv. 2003;3:353–67.

    Article  Google Scholar 

  146. Schrieber F, Witthoft M, Neng JM, Weck F. Changes in negative implicit evaluations in patients of hypochondriasis after treatment with cognitive therapy or exposure therapy. J Behav Ther Exp Psychiatry. 2016;50:139–46.

    Article  Google Scholar 

  147. Seivewright H, Green J, Salkovskis P, Barret B, Nur U, Tyrer P. Cognitive-behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised control trial. Br J Psychiatry. 2008;193:332–7.

    Article  PubMed  Google Scholar 

  148. Sorenson P, Birket-Smith M, Wattar U, Buemann I. A randomized clinical trial of cognitive behavioral therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis. Psychol Med. 2011;41(2):431–41.

    Article  Google Scholar 

  149. Tyrer P, Cooper S, Salkovskis P, Tyrer H, Crawford M, Byford S, et al. Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: a multicentre randomized control trial. Lancet. 2014;383:219–25.

    Article  PubMed  Google Scholar 

  150. Visser S, Bouman TK. The treatment of hypochondriasis: exposure plus response prevention vs. cognitive therapy. Behav Res Ther. 2001;39:423–42.

    Article  CAS  PubMed  Google Scholar 

  151. Weck F, Neng JM. Response and remission after cognitive and exposure therapy for hypochondriasis. J Nerv Ment Dis. 2015;203(11):883–5.

    Article  PubMed  Google Scholar 

  152. Weck F, Neng JM, Richtberg S, Jakob M, Stangier U. Cognitive therapy versus exposure therapy for hypochondriasis (health anxiety): a randomized control trial. J Consult Clin Psychol. 2015;83(4):665–76.

    Article  PubMed  Google Scholar 

  153. Avia MD, Ruiz A, Olivaries ME, Cespo M, Guisado AB, Sandhez A, et al. The meaning of psychological symptoms: effectiveness of a group intervention with hypochondriacal patients. Behav Res Ther. 1996;34:23–31.

    Article  CAS  PubMed  Google Scholar 

  154. Hedman E, Ljotsson B, Andersson E, Ruck C, Andersson G, Lindefors N. Effectiveness and cost offset analysis of group CBT for hypochondriasis delivered in a psychiatric setting: an open trial. Cogn Behav Ther. 2010;39:239–50.

    Article  PubMed  Google Scholar 

  155. Hedman E, Anddersson G, Anderrsson E, Ljotsson B, Ruck C, Asmundson GJ, et al. Internet-based cognitive behavioural therapy for severe health anxiety: randomised controlled trial. Br J Psychiatry. 2011;198:230–6.

    Article  PubMed  Google Scholar 

  156. Weck F, Gropalis M, Hiller W, Bleichhardt G. Effectiveness of cognitive-behavioral group therapy for patients with hypochondriasis (health anxiety). J Anxiety Disord. 2015;30:1–7.

    Article  PubMed  Google Scholar 

  157. Hedman E, Andersson E, Linderfors N, Anderrson G, Ruck C, Ljotsson B. Cost-effectiveness and long-term effectiveness of internet-based cognitive behaviour therapy for severe health anxiety. Psychol Med. 2013;43(2):363–74.

    Article  CAS  PubMed  Google Scholar 

  158. Hedman E, Axelsson E, Andersson E, Lekander M, Liotsson B. Exposure-based cognitive-behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and Illness anxiety disorder: randomised control trial. Br J Psychiatry. 2016;209(5):407–13.

    Article  PubMed  Google Scholar 

  159. Hedman E, Exelsson E, Gorling A, Ritzman C, Ronnheden M, El Alaoui S, et al. Internet-delivered exposure-based cognitive-behavioural therapy and behavioral stress management for severe health anxiety: randomised control trial. Br J Psychiatry. 2014;205:307–14.

    Article  PubMed  Google Scholar 

  160. Nakao M, Shinozaki Y, Nolido N, Ahern DK, Barsky AJ. Responsiveness of hypochondriacal patients with chronic low back pain to cognitive-behavioral therapy. Psychosomatics. 2012;53:139–47.

    Article  PubMed  Google Scholar 

  161. Eilenberg T. Acceptance and Commitment Group Therapy (ACT-G) for health anxiety: a randomized, controlled trial. Dan J Med. 2015;63(10):85294.

    Google Scholar 

  162. Eilenberg T, Fink P, Jensen JS, Rief W, Frostholm L. Acceptance and Commitment Group Therapy (ACT-G) for health anxiety: a randomized controlled trial. Psychol Med. 2016;46(1):103–15.

    Article  CAS  PubMed  Google Scholar 

  163. Lovas DA, Barsky AJ. Mindfulness based cognitive therapy for hypochondriasis, or severe health anxiety: a pilot study. J Anxiety Disord. 2010;24:931–5.

    Article  PubMed  Google Scholar 

  164. McManus F, Surawy C, Muse K, Vazquez-Montes M, Williams JM. A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). J Consult Clin Psychol. 2012;80:817–28.

    Article  PubMed  PubMed Central  Google Scholar 

  165. Stone J, Warlow C, Sharpe M. The symptom of functional weakness: a controlled study of 107 patients. Brain. 2010;133(5):1537–51.

    Article  PubMed  Google Scholar 

  166. Stone J, Aybek S. Functional limb weakness and paralysis. Handb Clin Neurol. 2016;139:213–28.

    Article  CAS  PubMed  Google Scholar 

  167. Thomas M, Vuong KD, Jankovic J. Long-term prognosis of patients with psychogenic movement disorders. Parkinsonism Relat Disord. 2006;12(6):382–7.

    Article  PubMed  Google Scholar 

  168. Cubo E, Hinson VK, Goetz CG, Ruiz PG, de Yebenes JG, Marti MJ, et al. Transcultural comparison of psychogenic movement disorders. Mov Disord. 2005;20(10):1343–5.

    Article  PubMed  Google Scholar 

  169. Jankovic J, Vuong KD, Thomas M. Psychogenic tremor: long term outcome. CNS Spectr. 2006;11:501–8.

    Article  PubMed  Google Scholar 

  170. Keane JR. Hysterical gait disorder: 60 cases. Neurology. 1989;39:586–9.

    Article  CAS  PubMed  Google Scholar 

  171. Lempert T, Dieterich M, Huppert D, Brandt T. Psychogenic disorders in neurology: frequency and clinical spectrum. Acta Neurol Scand. 1990;82:335–40.

    Article  CAS  PubMed  Google Scholar 

  172. Ng K, Lee J, Mui W. Aphonia induced by conversion disorder during a Cesarean section. Acta Anaesthesiol Taiwan. 2012;50(3):138–41.

    Article  PubMed  Google Scholar 

  173. Baslet G, Seshadri A, Bermeo-Ovalle A, Willment K, Myers L. Psychogenic non-epileptic seizures: an updated primer. Psychosomatics. 2016;51:1–17.

    Article  Google Scholar 

  174. Ghaffar O, Staines R, Feinstein A. Unexplained neurologic symptoms: an fMRI study of sensory conversion disorder. Neurology. 2006;67(11):2036–8.

    Article  PubMed  Google Scholar 

  175. Rolak LA. Psychogenic sensory loss. J Nerv Ment Dis. 1988;176(11):686–7.

    Article  CAS  PubMed  Google Scholar 

  176. Tiihonen J, Kuikka J, Viinamki H, Lehtonen J, Partanen J. Altered cerebral blood flow during hysterical paresthesia. Biol Psychiatry. 1995;37(2):134–5.

    Article  CAS  PubMed  Google Scholar 

  177. Villegas RB, Ilsen PF. Functional visual loss: a diagnosis of exclusion. Optometry. 2007;78:523–33.

    Article  PubMed  Google Scholar 

  178. Breuer J. Fraulein Anna O. In: The complete works of Sigmund Freud, vol. II. standard ed. London: Hogarth Press; 1895/1974. p. 21–47.

    Google Scholar 

  179. Mott AE, Grushka M, Sessle BJ. Diagnosis and management of taste disorders and burning mouth syndrome. Dent Clin N Am. 1993;37(1):33–71.

    CAS  PubMed  Google Scholar 

  180. Austen S, Lych C. Non-organic hearing loss redefined: understanding, categorizing, and managing non-organic behavior. Int J Audiol. 2004;43(8):449–57.

    Article  PubMed  Google Scholar 

  181. Dwyer J, Reid S. Ganser’s syndrome. Lancet. 2004;364:471–3.

    Article  PubMed  Google Scholar 

  182. Delis DC, Wetter SR. Cogniform disorder and cogniform condition: proposed diagnosis for excessive cognitive symptoms. Arch Clin Neuropsychol. 2007;22(5):589–604.

    Article  PubMed  Google Scholar 

  183. Stone J, Reuber M, Carson A. Functional symptoms in neurology: mimics and chameleons. Pract Neurol. 2013;13:104–13.

    Article  PubMed  Google Scholar 

  184. Ganos C, Edwards MJ, Bhatia KP. Posttraumatic functional movement disorders. Handb Clin Neurol. 2016;139:499–507.

    Article  CAS  PubMed  Google Scholar 

  185. Stone J, Carson A, Aditya H, Prescott R, Zaubi M, Warlow C, et al. The role of physical injury in motor and sensory conversion symptoms: a systematic and narrative review. J Psychosom Res. 2009;66(5):383–90.

    Article  PubMed  Google Scholar 

  186. Daum C, Hubschmid M, Aybek S. The value of ‘positive’ clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review. J Neurol Neurosurg Psychiatry. 2014;85:180–90.

    Article  PubMed  Google Scholar 

  187. Avbersek A, Sisodiya S. Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures? J Neurol Neurosurg Psychiatry. 2010;81:719–25.

    Article  PubMed  Google Scholar 

  188. Vossler DG, Haltiner AM, Schlepp SK, Friel PA, Caylor LM, Morgan JD, Dohery MJ. Ictal stuttering: a sign suggestive of psychogenic nonepileptic seizures. Neurology. 2004;63(3):516–9.

    Article  CAS  PubMed  Google Scholar 

  189. Factor SA, Podskalny GD, Molho ES. Psychogenic movement disorders: frequency, clinical profile, and characteristics. J Neurol Neurosurg Psychiatry. 1995;59:406–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  190. Stone J, Smyth R, Carson A, Warlow C, Sharpe M. La belle indifference in conversion symptoms and hysteria: systematic review. Br J Psychiatry. 2006;188:204–9.

    Article  PubMed  Google Scholar 

  191. Hoerth MT, Wellik KE, Demaerschalk BM. Clinical predictors of psychogenic nonepileptic seizures: a critically appraised topic. Neurologist. 2008;14:266–70.

    Article  PubMed  Google Scholar 

  192. Boissy AR, Ford PJ. A touch of MS – therapeutic mislabeling. Neurology. 2012;78:1981–5.

    Article  PubMed  Google Scholar 

  193. Paulson GW. Pseudo-multiple sclerosis. South Med J. 1996;89(3):301–4.

    Article  CAS  PubMed  Google Scholar 

  194. Merwick A, Sweeney BJ. Functional symptoms in clinically definite MS—pseudo-relapse syndrome. Int MS J. 2008;15(2):47–51.

    CAS  PubMed  Google Scholar 

  195. Nicolson R, Feinstein A. Conversion, dissociation, and multiple sclerosis. J Nerv Ment Dis. 1994;182(11):668–9.

    Article  CAS  PubMed  Google Scholar 

  196. Pavlou M, Stefoski D. Development of somatizing responses in multiple sclerosis. Psychother Psychosom. 1983;39:236–43.

    Article  CAS  PubMed  Google Scholar 

  197. Stone J, Carson A, Duncan R, Coleman R, Roberst R, Warlow C, et al. Symptoms ‘unexplained by organic disease’ in 1144 new neurology outpatients: how often does the diagnosis change at follow-up? Brain. 2009;132(1):2878–88.

    Article  PubMed  Google Scholar 

  198. Williams DT, Ford B, Fahn S. Phenomenology and psychopathology related to psychogenic movements disorders. Adv Neurol. 1995;65:231–57.

    CAS  PubMed  Google Scholar 

  199. Benbadis SR, O’Neill E, Tatum WO, Heriaud L. Outcome of prolonged video-EEG monitoring at a typical referral epilepsy center. Epilepsia. 2004;45:1150–3.

    Article  PubMed  Google Scholar 

  200. LaFrance WC, Benbadis SR. Differentiating frontal lobe epilepsy from psychogenic nonepileptic seizures. Neurol Clin. 2011;29:149–62.

    Article  PubMed  Google Scholar 

  201. Matin N, Young SS, Williams B, LaFrance WC Jr, King JN, Caplan D, et al. Neuropsychiatric associations with gender, illness duration, work disability, and motor subtype in a US functional neurological disorders clinic population. J Neuropsychiatr Clin Neurosci. 2017;29:375–82.

    Article  Google Scholar 

  202. McKenzie PS, Oto M, Graham CD, Duncan R. Do patients whose psychogenic non-epileptic seizures resolve, ‘replace’ them with other medically unexplained symptoms? Medically unexplained symptoms arising after a diagnosis of psychogenic non-epileptic seizures. J Neurol Neurosurg Psychiatry. 2011;82(9):967–9.

    Article  PubMed  Google Scholar 

  203. Carson A, Ludwig L, Welch K. Psychologic theories in functional neurologic disorders. Handb Clin Neurol. 2016;139:105–20.

    Article  CAS  PubMed  Google Scholar 

  204. Perez DL, Barsky AJ, Daffner K, Silbersweig DA. Motor and somatosensory conversion disorder: a functional unawareness syndrome? J Neuropsychiatr Clin Neurosci. 2012;24(2):141–51.

    Article  Google Scholar 

  205. Demartini B, Goeta D, Romito L, Anselmetti S, Bertelli S, D’Agostino A, et al. Anorexia nervosa and functional motor symptoms: two faces of the same coin? J Neuropsychiatr Clin Neurosci. 2017;29:383–90.

    Article  Google Scholar 

  206. Carson A, Stone J, Hibberd C, Murray G, Duncan R, Coleman R, et al. Disability, distress and unemployment in neurology outpatients with symptoms ‘unexplained by disease’. J Neurol Neurosurg Psychiatry. 2011;82:810–3.

    Article  CAS  PubMed  Google Scholar 

  207. Crimlisk HL, Bhatia K, Cope H, et al. Slater revisited: 6 year follow up study of patients with medically unexplained motor symptoms. BMJ. 1998;316(7131):582–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  208. Feinstein A, Stergiopoulos V, Fine J, Lang AE. Psychiatric outcome in patients with a psychogenic movement disorder: a prospective study. Neuropsychiatry Neuropsychol Behav Neurol. 2001;14(3):169–76.

    CAS  PubMed  Google Scholar 

  209. Diprose W, Sundram F, Menkes DB. Psychiatric comorbidity in psychogenic nonepileptic seizures compared with epilepsy. Epilepsy Behav. 2016;56:123–30.

    Article  PubMed  Google Scholar 

  210. Ekanayake V, Kranick S, LaFaver K, Naz A, Webb AF, LaFrance WC Jr, et al. Personality traits in psychogenic non-epileptic seizures (PNES) and psychogenic movement disorder (PMD): neuroticism and perfectionism. J Psyschosom Res. 2017;97:23–9.

    Article  Google Scholar 

  211. Anderson KE, Gruber-Baldini AL, Vaughan CG, Reich SG, Fishman PS, Weiner WJ, et al. Impact of psychogenic movement disorders versus Parksinson’s on disability, quality of life, and psychopathology. Mov Disord. 2007;22(15):2204–9.

    Article  PubMed  Google Scholar 

  212. Simon G, Gater R, Kisely S, Piccinelli M. Somatic symptoms of distress: an international primary care study. Psychosom Med. 1996;58(5):481–8.

    Article  CAS  PubMed  Google Scholar 

  213. Stone J, Hewett R, Carson A, Warlow C, Sharpe M. The ‘disappearance’ of hysteria: historical mystery or illusion? J R Soc Med. 2008;101(1):12–8.

    Article  PubMed  PubMed Central  Google Scholar 

  214. Binzer M, Kullgren G. Motor conversion disorder. A prospective 2- to 5-year follow-up study. Psychosomatics. 1998;39:519–27.

    Article  CAS  PubMed  Google Scholar 

  215. Ewald H, Rogne T, Ewald K, Fink P. Somatization in patients newly admitted to a neurological department. Acta Psychiatr Scand. 1994;89:174–9.

    Article  CAS  PubMed  Google Scholar 

  216. Folks DG, Ford CV, Regan WM. Conversion symptoms in a general hospital. Psychosomatics. 1984;25:285.

    Article  CAS  PubMed  Google Scholar 

  217. Gelauff J, Stone J, Edwards M, Carson A. The prognosis of functional (psychogenic) motor symptoms: a systematic review. J Neurol Neurosurg Psychiatry. 2014;85(2):220–6.

    Article  PubMed  Google Scholar 

  218. Roy A. Hysteria: a case note study. Can J Psychiatry. 1979;24:157–60.

    Article  CAS  PubMed  Google Scholar 

  219. Feinstein A, Stergiopoulos V, Fine J, Lang AF. Psychiatric outcome in patients with a psychogenic movement disorder: a prospective study. Neuropsychiatry Neuropsychol Behav Neurol. 2001;14(3):169–76.

    CAS  PubMed  Google Scholar 

  220. Stefansson JG, Messina JA, Meyerowitz S. Hysterical neurosis, conversion type: clinical and epidemiological considerations. Acta Psychiatr Scand. 1976;53:119–38.

    Article  CAS  PubMed  Google Scholar 

  221. Sharpe M, Stone J, Hibberd C, Warlow C, Duncan R, Coleman R, et al. Neurology out-patients with symptoms unexplained by disease: illness beliefs and financial benefits predict 1-year outcome. Psychol Med. 2010;40(4):689–98.

    Article  CAS  PubMed  Google Scholar 

  222. Dallocchio C, Arbasino C, Klersy C, Marchioni E. The effects of physical activity on psychogenic movement disorders. Mov Disord. 2010;25(4):421–5.

    Article  PubMed  Google Scholar 

  223. Kompoliti K, Wilson B, Stebbins G, Bernard B, Hinson V. Immediate vs. delayed treatment of psychogenic movement disorders with short term psychodynamic psychotherapy: randomized clinical trial. Parkinsonism Relat Disord. 2014;20(1):60–3.

    Article  PubMed  Google Scholar 

  224. Sharma VD, Jones R, Factor SA. Psychodynamic psychotherapy for functional (psychogenic) movement disorders. J Mov Disord. 2017;10(1):40–4.

    Article  PubMed  Google Scholar 

  225. Goldstein LH, Chalder T, Chigwedere C, Kondoker MR, Moriarty J, Toone BK, et al. Cognitive behavioral therapy for psychogenic non-epileptic seizures: a pilot RCT. Neurology. 2010;74(24):1986–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  226. LaFrance CW Jr, Baird GL, Barry JJ, Blum AS, Webb AF, Keitner GI, et al. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiat. 2014;71(9):997–1005.

    Article  Google Scholar 

  227. Baslet G, Dworetzky B, Perez DL, Oser M. Treatment of psychogenic nonepileptic seizures: updated review and findings from a mindfulness-based intervention case series. Clin EEG Neurosci. 2015;46(1):54–64.

    Article  PubMed  Google Scholar 

  228. Bullock KD, Mirza N, Forte C, Trockel M. Group dialectical-behavior therapy skills training for conversion disorder with seizures. J Neuropsychiatr Clin Neurosci. 2015;27:240–3.

    Article  Google Scholar 

  229. Metin SZ, Ozmen M, Metin B, Talasman S, Yeni SN, Ozkara C. Treatment with group psychotherapy for chronic psychogenic nonepileptic seizures. Epilepsy Behav. 2013;28(1):91–4.

    Article  PubMed  Google Scholar 

  230. Barry JJ, Wittenberg D, Bullock KD, Michaels JB, Classen CC, Fisher RS. Group therapy for patients with psychogenic nonepileptic seizures: a pilot study. Epilepsy Behav. 2008;13(4):624–9.

    Article  CAS  PubMed  Google Scholar 

  231. Baslet G. Psychogenic nonepileptic seizures: a treatment review. What have we learned since the beginning of the millennium? Neuropsychiatr Dis Treat. 2012;8:585–98.

    Article  PubMed  PubMed Central  Google Scholar 

  232. Zaroff CM, Myers L, Barr WB, Luciano D, Devinsky O. Group psychoeducation as treatment for psychological nonepileptic seizures. Epilepsy Behav. 2004;5(4):587–92.

    Article  PubMed  Google Scholar 

  233. Bravo TP, Hoffman-Snyder CR, Wellik KE, Martin KA, Hoerth MT, Demaerschalk BM, et al. The effect of selective serotonin reuptake inhibitors on the frequency of psychogenic nonepileptic seizures: a critically appraised topic. Neurologist. 2013;19(1):30–3.

    Article  PubMed  Google Scholar 

  234. LaFrance WC Jr, Keitner GI, Papandonatos GD, Blum AS, Machan JT, Ryan CE, et al. Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures. Neurology. 2010;75(13):1166–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  235. Nicholson TRJ, Voon V. Transcranial magnetic stimulation and sedation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:619–29.

    Article  CAS  PubMed  Google Scholar 

  236. Deeley Q. Hypnosis as therapy for functional neurologic disorders. Handb Clin Neurol. 2016;139:585–95.

    Article  CAS  PubMed  Google Scholar 

  237. Heruti RJ, Levy A, Adunsi A, Ohry A. Conversion motor paralysis disorder: overview and rehabilitation. Spinal Cord. 2002;40:327–34.

    Article  CAS  PubMed  Google Scholar 

  238. Neilsen G, Stone J, Matthews A, Brown M, Spankes C, Farmer R, et al. Physiotherapy for functional motor disorders: a consensus recommendation. J Neurol Neurosurg Psychiatry. 2015;86(10):1113–9.

    Article  Google Scholar 

  239. Ness D. Physical therapy management for conversion disorder: case series. JNPT. 2007;31:30–9.

    PubMed  Google Scholar 

  240. McCormack R, Moriarty J, Mellers JD, Shotbolt P, Pastena R, Landes N, et al. Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study. J Neurol Neurosurg Psychiatry. 2014;85(8):895–900.

    Article  PubMed  Google Scholar 

  241. Shapiro AP, Teasell RW. Behavioural interventions in the rehabilitation of acute v. chronic non-organic (conversion/factitious) motor disorders. Br J Psychiatry. 2004;185(2):140–6.

    Article  PubMed  Google Scholar 

  242. Williams DT, Lafaver K, Carson A, Fahn S. Inpatient treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:631–41.

    Article  CAS  PubMed  Google Scholar 

  243. Jirsch JD, Ahmed SN, Maximova K, Gross DW. Recognition of psychogenic nonepileptic seizures diminishes acute care utilization. Epilepsy Behav. 2011;22(2):304–7.

    Article  CAS  PubMed  Google Scholar 

  244. Razvi S, Mulhern S, Duncan R. Newly diagnosed psychogenic nonepileptic seizures: health care demand prior to and following diagnosis at a first seizure clinic. Epilepsy Behav. 2012;23(1):7–9.

    Article  PubMed  Google Scholar 

  245. Hall-Patch L, Brown R, House A, Howlett S, Kemp S, Lawton G, NEST collaborators, et al. Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures. Epilepsia. 2010;51(1):70–8.

    Article  PubMed  Google Scholar 

  246. Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543–53.

    Article  CAS  PubMed  Google Scholar 

  247. Shen W, Bowman ES, Markand ON. Presenting the diagnosis of pseudoseizure. Neurology. 1990;40(5):756–9.

    Article  CAS  PubMed  Google Scholar 

  248. Bass C, Halligan P. Factitious disorders and malingering in relation to functional neurologic disorders. Handb Clin Neurol. 2016;139:509–20.

    Article  CAS  PubMed  Google Scholar 

  249. Yates GP, Feldman MD. Factitious disorder: a systematic review of 455 cases in the professional literature. Gen Hosp Psychiatry. 2016;41:20–8.

    Article  PubMed  Google Scholar 

  250. Heimbach D, Bruhl P. Urological aspects of Munchausen’s syndrome. Eur Urol. 1997;31(3):371–5.

    Article  CAS  PubMed  Google Scholar 

  251. Hamre MC, Nguyen PH, Shepard SE, Caplan JP. Factitious mastectomy: the importance of staying abreast of the medical record. Psychosomatics. 2014;55:186–90.

    Article  PubMed  Google Scholar 

  252. Pessina AC, Bisogni V, Fassina A, Rossi GP. Munchausen syndrome: a novel cause of drug resistant hypertension. J Hypertens. 2013;31(7):1473–6.

    Article  CAS  PubMed  Google Scholar 

  253. Fliegner JR. Munchausen’s syndrome and self-induced illness in gynaecology. Med J Aust. 1983;2(12):666–7.

    CAS  PubMed  Google Scholar 

  254. Fliege H, Grimm A, Eckhardt-Henn A, Gieler U, Martin K, Klapp BF. Frequency of ICD-10 factitious disorder: survey of senior hospital consultants and physicians in private practice. Psychosomatics. 2007;48(1):60–4.

    Article  PubMed  Google Scholar 

  255. Ucmak D, Harman M, Akkurt ZM. Dermatitis artefacta: a retrospective analysis. Cutan Ocul Toxicol. 2014;33(1):22–7.

    Article  PubMed  Google Scholar 

  256. Tomas-Aragones L, Consoli SM, Consoli SG, Poot F, Taube K, Linder MD, et al. Self-inflicted lesions in dermatology: a management and therapeutic approach- a position paper from the European society for dermatology and psychiatry. Acta Derm Venereol. 2017;97:159–72.

    Article  PubMed  Google Scholar 

  257. Krahn L, Bostwick J, Stonnington C. Looking towards DSM-5: should factitious disorder become a subtype of somatoform disorder? Psychosomatics. 2008;49:277–82.

    Article  PubMed  Google Scholar 

  258. Kanaan RA, Wessely SC. Factitious disorders in neurology: an analysis of reported cases. Psychosomatics. 2010;51(1):47–54.

    Article  PubMed  Google Scholar 

  259. Bass C, Halligan P. Factitious disorders and malingering: challenges for clinical assessment and management. Lancet. 2014;383(9926):142–1432.

    Google Scholar 

  260. Krahn L, Honghzhe L, O’Connor K. Patients who strive to be ill: factitious disorder with physical symptoms. Am J Psychiatr. 2003;160:1163–8.

    Article  PubMed  Google Scholar 

  261. Hamilton JC, Eger M, Razzak S, Feldman MD, Hallmark N, Cheek S. Somatoform, factitious, and related diagnosis in the national discharge survey: addressing the proposed DSM-5 revision. Psychosomatics. 2013;54:142–8.

    Article  PubMed  Google Scholar 

  262. Goldstein AB. Identification and classification of factitious disorders: an analysis of cases reported during a ten year period. Int J Psychiatry Med. 1998;28(2):221–41.

    Article  CAS  PubMed  Google Scholar 

  263. Yates G, Bass C. The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) – a systematic review of 796 cases. Child Abuse Negl. 2017;72:45–53.

    Article  PubMed  Google Scholar 

  264. Jones TW, Delplanche ML, Davies NP, Rose CH. Factitious disorder by proxy simulating fetal growth restriction. Obstet Gynecol. 2015;125(3):732–4.

    Article  PubMed  Google Scholar 

  265. Hoertel N, Lavaud P, Le Strat Y, Gorwood P. Estimated cost of a factitious disorder with 6-year follow-up. Psychiatry Res. 2012;200:107–8.

    Google Scholar 

  266. Vaduganathan M, McCullough SA, Fraser TN, Stern TA. Death due to Munchausen syndrome: a case of idiopathic recurrent right ventricular failure and a review of the literature. Psychosomatics. 2014;55(6):668–72.

    Article  PubMed  Google Scholar 

  267. Bass C, Taylor M. Recovery from chronic factitious disorder (Munchausen’s syndrome): a personal account. Personal Ment Health. 2013;7(1):80–3.

    Article  PubMed  Google Scholar 

  268. Feldman M. Recovery from Munchausen’s syndrome. South Med J. 2006;99:1398–9.

    Article  PubMed  Google Scholar 

  269. Higgins P. Temporary Munchausen’s syndrome. Br J Psychiatry. 1990;157:613–6.

    Article  CAS  PubMed  Google Scholar 

  270. Axelsson E, Andersson E, Ljotsson B, Wallhed Finn D, Hedman E. The health preoccupation diagnostic interview: inter-rater reliability of a structured interview for diagnostic assessment of DSM-5 somatic symptom disorder and illness anxiety disorder. Cogn Behav Ther. 2016;45(4):259–69.

    Article  PubMed  Google Scholar 

  271. Brown TA, Barlow D. Anxiety and related disorder interview schedule for DSM-5 (ADIS-5). New York: Oxford University Pres; 2014.

    Google Scholar 

  272. Barsky AJ, Cleary PD, Wyshak G, Spitzer RL, Williams JB, Klerman GL. A structured diagnostic interview for hypochondriasis. A proposed criterion standard. J Nerv Ment Dis. 1992;180(1):20–7.

    Article  CAS  PubMed  Google Scholar 

  273. Hinson VK, Cubo E, Comella CL, Goetz CG, Leurgans S. Rating scale for psychogenic movement disorders: scale development and clinimetric testing. Mov Disord. 2005;20(12):1592–7.

    Article  PubMed  Google Scholar 

  274. Salkovskis P, Rimes K, Warwick H, Clark D. The health anxiety inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol Med. 2002;32:843–53.

    Article  CAS  PubMed  Google Scholar 

  275. Greeven A, Spinhoven P, van Balkom AJLM. Hypochondriasis Y-BOCS: a study of the psychometric properties of a clinician administered semi-structured interview to assess hypochondriacal thoughts and behaviors. Clin Psychol Psychother. 2009;16:431–43.

    Article  PubMed  Google Scholar 

  276. Wright KD, Asmundson GJ. Health anxiety in children: development and psychometric properties on the childhood illness attitudes scales. Cogn Behav Ther. 2003;32:194–202.

    Article  PubMed  Google Scholar 

  277. McElroy E, Shevlin M. The development and initial validation of the cyberchondria severity scale (CSS). J Anxiety Disord. 2014;28(2):259–65.

    Article  PubMed  Google Scholar 

  278. Kroenke K, Spitzer RI, Williams JBW. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med. 2002;64:258–66.

    Article  PubMed  Google Scholar 

  279. Barsky AJ, Wyshak G, Klerman GL. The somatosensory amplification scale and its relationship to hypochondriasis. J Psychiatr Res. 1990;24:323–34.

    Article  CAS  PubMed  Google Scholar 

  280. Nijenhuis ERS, Spinhoven P, Van Dyck R, Van der Hart O, Vanderlinden J. The development and the psychometric characteristics of the Somatoform Dissociation Questionnaire (SDQ-20). J Nerv Ment Dis. 1996;184:688–94.

    Article  CAS  PubMed  Google Scholar 

  281. Shields SS, Mallory ME, Simon A. The body awareness questionnaire: reliability and validity. J Pers Assess. 1989;53(4):802–15.

    Article  Google Scholar 

  282. Schmidt NB, Lerew DR, Trakowski JH. Body vigilance in panic disorder: evaluating attention to bodily perturbations. J Consult Clin Psychol. 1997;65(2):214–20.

    Article  CAS  PubMed  Google Scholar 

  283. Price CJ, Thompson EA. Measuring dimensions of body connection: body awareness and bodily dissociation. J Altern Complement Med. 2007;13(9):945–53.

    Article  PubMed  Google Scholar 

  284. Barsky A. Hypochondriasis and panic disorder: boundary and overlap. Arch Gen Psychiatry. 1994;51:918–25.

    Article  CAS  PubMed  Google Scholar 

  285. McGilchrist I, Cutting J. Somatic delusions in schizophrenia and the affective psychoses. Br J Psychiatry. 1995;167(3):350–61.

    Article  CAS  PubMed  Google Scholar 

  286. Greeven A, van Balkom AJ, van Rood YR, van Oppen P, Spinhoven P. The boundary between hypochondriasis and obsessive-compulsive disorder: a cross-sectional study from the Netherlands. J Clin Psychiatry. 2006;67(11):1682–9.

    Article  PubMed  Google Scholar 

  287. Katon W, Kleinman A, Rosen W. Depression and somatization: a review, part I. Am J Med. 1982;72:127–35.

    Article  CAS  PubMed  Google Scholar 

  288. Katon W, Kleinman A, Rosen W. Depression and somatization: a review, part II. Am J Med. 1982;72:241–7.

    Article  CAS  PubMed  Google Scholar 

  289. Van der Kolk BA, Pelcovitz D, Roth S, Mandel FS, McFarlane A, Herman JL. Dissociation, somatization, and affect dysregulation: the complexity of adaptation to trauma. Am J Psychiatr. 1996;153(7):83–93.

    Article  PubMed  Google Scholar 

  290. Tasca C, Rappetti M, Carta MG, Fadda B. Women and hysteria in the history of mental health. Clin Pract Epidemiol Ment Health. 2012;8:110–9.

    Article  PubMed  PubMed Central  Google Scholar 

  291. Fahrenberg J. Somatic complaints in the German population. J Psychosom Res. 1995;39:809–17.

    Article  CAS  PubMed  Google Scholar 

  292. Haavio-Mannila E. Inequalities in health and gender. Soc Sci Med. 1991;32:579–90.

    Article  Google Scholar 

  293. Ladwig KH, Marten-Mittag B, Formanek B. Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol. 2000;16:511–8.

    Article  CAS  PubMed  Google Scholar 

  294. Kandrack MA, Grant KR, Segall A. Gender differences in health related behavior: some unanswered questions. Soc Sci Med. 1993;36:21–32.

    Article  Google Scholar 

  295. Kroenke K, Spitzer RL. Gender differences in the reporting of physical and somatoform symptoms. Psychosom Med. 1998;60:150–5.

    Article  CAS  PubMed  Google Scholar 

  296. Popay J, Bartley M, Owen C. Gender inequalities in health: social position, affective disorders, and minor physical morbidity. Soc Sci Med. 1993;36:21–32.

    Article  CAS  PubMed  Google Scholar 

  297. Verbrugge LM, Wingard DL. Sex differentials in health and mortality. Women Health. 1982;12:103–45.

    Article  Google Scholar 

  298. Fink P, Toft T, Hansen MS, Ornbol E, Olesen F. Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosom Med. 2007;69(1):30–9.

    Article  PubMed  Google Scholar 

  299. Bujoreanu S, Randall E, Thomson K, Ibeziako P. Characteristics of medically hospitalized pediatric patients with somatoform diagnoses. Hosp Pediatr. 2014;4(5):283–90.

    Article  PubMed  Google Scholar 

  300. Cloninger SR, Martin RL, Guze SB, Clayton PJ. A prospective follow-up and family study of somatization in men and women. Am J Psychiatry. 1986;143:873–8.

    Article  CAS  PubMed  Google Scholar 

  301. Faravelli C, Solvatori S, Galassi F, Aiazzi L, Drei C, Cavras P. Epidemiology of somatoform disorders: a community survey in Florence. Soc Psychiatry Psychiatr Epidemiol. 1997;32:24–9.

    Article  CAS  PubMed  Google Scholar 

  302. Furnham A, Kirkcald B. Age and sex differences in health beliefs and behaviours. Psychol Rep. 1991;80:63–6.

    Article  Google Scholar 

  303. Golding JM, Smith GR, Kashner TM. Does somatization disorder occur in men? Clinical characteristics of women and men with multiple unexplained somatic symptoms. Arch Gen Psychiatry. 1991;48:231–5.

    Article  CAS  PubMed  Google Scholar 

  304. Kellner R. Hypochondriasis and somatization. JAMA. 1987;258:2718–22.

    Article  CAS  PubMed  Google Scholar 

  305. Ladwig KH, Marten-Mittag B, Erazo N, Gundel H. Identifying somatization disorder in a population-based health examination survey: psychosocial burden and gender differences. Psychosomatics. 2001;42:511–78.

    Article  CAS  PubMed  Google Scholar 

  306. Smith GR, Monson RA, Ray DC. Patients with multiple unexplained symptoms: their characteristics, functional health, and health care utilization. Arch Intern Med. 1986;146:69–72.

    Article  PubMed  Google Scholar 

  307. Silverstein B. Gender differences in the prevalence of clinical depression: the role played by depression associated with somatic symptoms. Am J Psychiatry. 1999;156:480–2.

    CAS  PubMed  Google Scholar 

  308. Silverstein B, Edwards T, Gamma A, Ajdacic-Gross V, Rossler W, Angst J. The role played by depression associated with somatic symptomology in accounting for the gender difference in the prevalence of depression. Soc Psychiatry Psychiatr Epidemiol. 2013;48:257–63.

    Article  CAS  PubMed  Google Scholar 

  309. Drossman DA, Whitehead WE, Camilleri M. Irritable bowel syndrome: a technical review for practice guideline development. Gastroenterology. 1997;112:212902137.

    Article  Google Scholar 

  310. Payne CK, Joyce GF, Wise M, Clemens JQ. Interstitial cystitis and painful bladder syndrome. J Urol. 2007;177:2042–9.

    Article  PubMed  Google Scholar 

  311. Wolfe F, Ross K, Anderson J, Ressell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38(1):19–28.

    Article  CAS  PubMed  Google Scholar 

  312. Bush FM, Harkins SW, Harrington WG, Pricc DD. Analysis of gender effects on pain perception and symptom perception in temporomandibular pain. Pain. 1993;53:73–80.

    Article  CAS  PubMed  Google Scholar 

  313. Collin SM, Bakken IJ, Nazareth I, Crawley E, White PD. Trends in the incidence of chronic fatigue syndrome and fibromyalgia in the UK, 2001–2013: a clinical practice research datalink study. J R Soc Med. 2017;110(6):231–44.

    Article  PubMed  PubMed Central  Google Scholar 

  314. Brunahl C, Dybowski C, Albrecht R, Riegel B, Hoink J, Fisch M, et al. Mental disorders in patients with chronic pelvic pain syndrome (CPPS). J Psychosom Res. 2017;98:19–26.

    Article  PubMed  Google Scholar 

  315. Farina B, Mazzotti E, Pasquini P, Mantione MG. Somatoform and psychoform dissociation among women with orgasmic and sexual pain disorders. J Trauma Dissoc. 2011;12:526–34.

    Article  Google Scholar 

  316. Berkley KJ. Sex differences in pain. Behav Brain Sci. 1997;20:371–80.

    Article  CAS  PubMed  Google Scholar 

  317. Chang L, Heitkemper MM. Gender differences in irritable bowel syndrome. Gastroenterology. 2002;123:1686–701.

    Article  PubMed  Google Scholar 

  318. Derbyshire SWG. Sources of variation in assessing male and female responses to pain. New Ideas Psychol. 1997;15:83–95.

    Article  Google Scholar 

  319. Fillingim RB, Maixner W. Gender differences in the response to noxious stimuli. Pain Forum. 1995;4:209–21.

    Article  Google Scholar 

  320. Fillinghim RB, Maixner W, Girdler SS, et al. Ischemic but not thermal pain sensitivity varies across the menstrual cycle. Psychosom Med. 1997;59:512–20.

    Article  Google Scholar 

  321. Ladwig KH, Marten-Mittag B, Formanek B, Dammann G. Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol. 2000;16:511–8.

    Article  CAS  PubMed  Google Scholar 

  322. Piccinelli M, Simon G. Gender and cross-cultural differences in somatic symptoms associated with emotional distress: an international study in primary care. Psychol Med. 1997;27:433–44.

    Article  CAS  PubMed  Google Scholar 

  323. Wool CA, Barsky AJ. Do women somatize more than men? Gender differences in somatization. Psychosomatics. 1994;35:445–52.

    Article  CAS  PubMed  Google Scholar 

  324. Kaminsky MJ, Slavney PR. Methodology and personality in Briquet’s syndrome: a reappraisal. Am J Psychiatry. 1976;133:85–8.

    Article  CAS  PubMed  Google Scholar 

  325. Doghor ON, Haimovici F, Mathias D, Knudson-Gonzalez D, Freid C. A determined woman: anxiety, unresolved mourning, and capacity assessment in recurrent pregnancy loss. Harv Rev Psychiatry. 2017;25(1):39–45.

    Article  PubMed  Google Scholar 

  326. Greene JA, Querques J, Barksy AJ, Notman M. Somatic preoccupations of future pregnancy. Harv Rev Psychiatry. 2011;19:86–94.

    Article  PubMed  Google Scholar 

  327. Kenner WD, Nicolson SE. Psychosomatic disorders of gravida status: false and denied pregnancies. Psychosomatics. 2015;56:119–28.

    Article  PubMed  Google Scholar 

  328. Gijsbers Van Wijk CMT, Kolk AM. Sex differences in physical symptoms: the contribution of symptom perception theory. Soc Sci Med. 1997;45(2):231–46.

    Article  Google Scholar 

  329. Otto MW, Dougher MJ. Sex differences in personality factors in responsivity to pain. Percept Mot Skills. 1985;61:383–90.

    Article  CAS  PubMed  Google Scholar 

  330. Jamison RN, Sbrocco T, Parris WCV. The influence of physical and psychosocial factors on accuracy of memory for pain in chronic pain patients. Pain. 1989;37:289–94.

    Article  CAS  PubMed  Google Scholar 

  331. Porzelius J. Memory for pain after nerve block injections. Clin J Pain. 1995;11:112–20.

    Article  CAS  PubMed  Google Scholar 

  332. Gove W, Hughes M. Possible causes of the apparent sex differences in physical health: an empirical investigation. Am Sociol Rev. 1979;44:126–46.

    Article  CAS  PubMed  Google Scholar 

  333. Scicchitano J, Lowell P, Pearce R, Marley J, Pilowsky I. Illness behavior and somatization in general practice. J Psychosom Res. 1996;41:247–54.

    Article  CAS  PubMed  Google Scholar 

  334. Klonoff EA, Landrine H, Brown M. Appraisal and response to pain may be a function of its bodily location. J Psychosom Res. 1993;37(6):661–70.

    Article  CAS  PubMed  Google Scholar 

  335. Nathanson CA. Sex, illness, and medical care: a review of data, theory, and method. Soc Sci Med. 1977;11:13–26.

    Article  CAS  PubMed  Google Scholar 

  336. Unruh AM. Gender variations in clinical pain experience. Pain. 1996;65:123–67.

    Article  CAS  PubMed  Google Scholar 

  337. Hall EG, Davies S. Gender differences in perceived intensity and affect of pain between athletes and nonathletes. Percept Mot Skills. 1991;73:779–86.

    Article  CAS  PubMed  Google Scholar 

  338. Klonoff EA, Landrine H. Sex roles, occupational roles, and symptom-reporting: a test of competing hypotheses on sex differences. J Behav Med. 1992;15(4):355–64.

    Article  CAS  PubMed  Google Scholar 

  339. Myers CD, Robinson ME, Riley JL, Sheffield D. Sex, gender, and blood pressure: contributions to experimental pain report. Psychosom Med. 2001;63:545–50.

    Article  CAS  PubMed  Google Scholar 

  340. Cloninger CR, Martin RL, Guze SG, Clayton PJ. A prospective follow-up and family study of somatization in men and women. Am J Psychiatry. 1986;143:873–8.

    Article  CAS  PubMed  Google Scholar 

  341. Cloninger CR, Sigvardsson S, von Knorring A, Bohman M. An adoption study of somatoform disorders II: identification of two discrete somatoform disorders. Arch Gen Psychiatry. 1984;41:863–71.

    Article  CAS  PubMed  Google Scholar 

  342. Cloninger CR, von Knorring A, Sigvardsson S, Bohman M. Symptom patterns and causes of somatization in men, part II: genetic and environmental independence from women. Genet Epidemiol. 1986;3:171–85.

    Article  CAS  PubMed  Google Scholar 

  343. Duncan R, Oto M, Martin E, Pelosi A. Late onset psychogenic nonepileptic attacks. Neurology. 2006;66:1644–7.

    Article  PubMed  Google Scholar 

  344. Bonvanie IJ, van Gila A, Janssens KAM, Rosmalen JGM. Sexual abuse predicts functional somatic symptoms: and adolescent population study. Child Abuse Negl. 2015;46:1–7.

    Article  PubMed  Google Scholar 

  345. Say GN, Tasdemir HA, Ince H. Semiological and psychiatric characteristics of children with psychogenic nonepileptic seizures: gender related differences. Seizure. 2015;31:144–8.

    Article  PubMed  Google Scholar 

  346. Thomas AA, Preston J, Scott RC, Bujarski KA. Diagnosis of probable psychogenic nonepileptic seizures in the outpatient clinic: does gender matter? Epilepsy Behav. 2013;29(2):295–7.

    Article  PubMed  Google Scholar 

  347. Mcfarlane AC, Atchison M, Rafalowicz E, Papay P. Physical symptoms in post-traumatic stress disorder. J Psychosom Res. 1994;38(7):715–26.

    Article  CAS  PubMed  Google Scholar 

  348. Kaiser M, Kuwert P, Braehler E, Glaesmer H. Depression, somatization, and posttraumatic stress disorder in children born of occupation after World War II in comparison with a general population. J Nerv Ment Dis. 2015;203:742–8.

    Article  PubMed  Google Scholar 

  349. Morina N, Kuenberg A, Schnyder U, Bryant RA, Nickerson A, Schick M. The association of post-traumatic and postmigration stress with pain and other somatic symptoms: an explorative analysis in traumatized refuges and asylum seekers. Pain Med. 2017;0:1–10.

    CAS  Google Scholar 

  350. Myers L, Perrine K, Lancman M, Fleming M, Lancman M. Psychological trauma in patients with psychogenic nonepileptic seizures: trauma characteristics and those who develop PTSD. Epilepsy Behav. 2013;28:121–6.

    Article  PubMed  Google Scholar 

  351. Fiszman A, Alves-Leon SV, Nunes RG, D’Andrea I, Figueira I. Traumatic events and posttraumatic stress disorder in patients with psychogenic nonepileptic seizures: a critical review. Epilepsy Behav. 2004;5(6):818–25.

    Article  PubMed  Google Scholar 

  352. Ibeziako P, Rohan JM, Bujoreanu S, Choi C, Hanrahan M, Freizinger M. Medically hospitalized patients with eating disorders and somatoform disorders in pediatrics: what are their similarities and differences and how can we improve their care? Hosp Pediatr. 2016;6(12):730–7.

    Article  PubMed  Google Scholar 

  353. Yamada K, Matsudaira K, Tanaka E, Oka H, Katsuhira J, Iso H. Sex-specific impact of early-life adversity on chronic pain: a large population based study in Japan. J Pain Res. 2017;10:427–33.

    Article  PubMed  PubMed Central  Google Scholar 

  354. Paivi M, Tanskanen A, Haatainen K, Koivumaa-Honkanen H, Hintikka J, Viinamaki H. Somatoform dissociation and adverse childhood experiences in the general population. J Nerv Ment Dis. 2004;192(5):337–42.

    Article  Google Scholar 

  355. Saxe GN, Chinman G, Berkowitz R, Hall K, Lieberg G, Schwartz J, et al. Somatization in patients with dissociative disorders. Am J Psychiatry. 1994;151:1329–34.

    Article  CAS  PubMed  Google Scholar 

  356. Bernstein B, Kane R. Physicians’ attitudes towards female patients. Med Care. 1981;19(6):600–8.. (362)

    Article  CAS  PubMed  Google Scholar 

  357. Colameco S, Becker LA, Simpson M. Sex bias in the assessment of patient complaints. J Fam Pract. 1983;16(6):1117–21.. (363)

    CAS  PubMed  Google Scholar 

  358. Verbrugge LM, Steiner RP. Physician treatment of men and women patients: sex bias or appropriate care? Med Care. 1981;19(6):609–32.

    Article  CAS  PubMed  Google Scholar 

  359. Hawkins CF, Cockel R. The prognosis and risk of missing malignant disease in patients with unexplained and functional diarrhea. Gut. 1971;12:208–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  360. Kroenke K, Wood DR, Mangelsdorff AD, Meier NJ, Powell JB. Chronic fatigue in primary care: prevalence, patent characteristics, and outcome. JAMA. 1988;260:929–34.

    Article  CAS  PubMed  Google Scholar 

  361. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA, et al. Causes of persistent dizziness: a prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117:898–904.

    Article  CAS  PubMed  Google Scholar 

  362. Stone J, Smyth R, Carson A, Lewis S, Prescott R, Warlow C, et al. Systematic review of misdiagnosis of conversion symptoms and “hysteria”. Br Med J. 2005;331:989.

    Article  Google Scholar 

  363. Sox HC, Margulies I, Sox CH. Psychologically mediated effects of diagnostic tests. Ann Intern Med. 1981;95:680–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA

    Timothy M. Scarella

Authors
  1. Timothy M. Scarella
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Timothy M. Scarella .

Editor information

Editors and Affiliations

  1. Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA

    Mary Angela O’Neal

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Scarella, T.M. (2019). Somatoform Disorders. In: O’Neal, M. (eds) Neurology and Psychiatry of Women. Springer, Cham. https://doi.org/10.1007/978-3-030-04245-5_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-04245-5_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04244-8

  • Online ISBN: 978-3-030-04245-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation