Somatic Symptom & Related Disorders

Somatic symptom and related disorders are mental health conditions in which real physical symptoms, or the fear of a serious illness, cause distress and take over daily life. In somatic symptom disorder, illness anxiety disorder and conversion disorder, the symptoms are genuine to the patient and are not produced on purpose. Conversion disorder shows up as a sudden neurologic deficit, such as paralysis, blindness or a nonepileptic seizure, usually after a stressful event, sometimes with a surprising lack of concern. Two look-alikes are intentional. In factitious disorder the patient fakes or causes symptoms to be cared for as a patient, and in malingering the goal is an outside reward like money or time off work. The nursing approach is the same for the unintentional group: acknowledge the symptoms as real, rule out physical disease once and then avoid repeat testing, schedule regular check-ins with one provider, and gently turn the conversation toward feelings, stress and coping. When a caregiver causes a child's illness, the child's safety comes first, and the nurse documents and reports.