Somatoform

Somatoform refers to a pattern of physical symptoms that are not fully explained by a medical condition and that are associated with disproportionate thoughts, feelings, or behaviors about those symptoms. Historically, the term encompassed several disorders in DSM-IV, including somatization disorder, hypochondriasis, undifferentiated somatoform disorder, somatoform autonomic disorder, and pain disorder. In DSM-5, these conditions were reorganized under the umbrella of Somatic Symptom and Related Disorders, which includes somatic symptom disorder, illness anxiety disorder, and conversion disorder (now termed functional neurological symptom disorder), along with related conditions such as factitious disorder and psychological factors affecting other medical conditions.

Clinical presentation typically involves one or more distressing physical symptoms (such as pain, fatigue, or neurological, gastrointestinal, or other symptoms) that are persistent and lead to significant impairment. The defining feature is disproportionate and persistent thoughts about the seriousness of the symptoms, high levels of health anxiety, and excessive time and energy devoted to the symptoms or health concerns. The course can be chronic and fluctuating, and it often co-occurs with mood or anxiety disorders.

Diagnosis requires careful clinical evaluation to exclude an underlying medical illness and to establish the symptom pattern and distress described in DSM-5 criteria. It is distinguished from malingering (intentional fabrication for external gain) and factitious disorder (intentional production or feigning of symptoms to assume the sick role). Treatment is typically multidisciplinary and biopsychosocial, emphasizing regular medical follow-up, education, and psychosocial therapies such as cognitive-behavioral therapy; pharmacotherapy may help manage comorbid depression or anxiety. The prognosis varies, with some individuals improving with treatment and others experiencing persistent symptoms.