eMedicine Specialties > Psychiatry > Psychosomatic
Somatoform Disorders: Differential Diagnoses & Workup
Updated: Feb 4, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Other Problems to Be Considered
Somatoform disorders must be differentiated from medical illnesses as well as from other psychiatric conditions; consider medical conditions that cause vague and diffuse symptoms. Also, consider somatization as part of a mood or anxiety disorder.
Cerebrovascular accidentEncephalopathy
Dialysis encephalopathy
Hepatic encephalopathy
Hypertensive encephalopathy, uremic
Goiter, chronic
Toxic hallucinogens
Heroin abuse
Lyme borreliosis
Multiple sclerosis
Workup
Laboratory Studies
- If indicated, specific studies used to rule out somatization due to general medical conditions include the following:
- Thyroid function studies - Thyroid stimulating hormone (TSH) at 0.4-10 mIU/L and thyroxine at 5.0-12.5 ng/dL
- Pheochromocytoma screen - Urine catecholamines, homovanillic acid (HVA) 2-12 mg per 24 hours, vanillylmandelic acid (VMA) 2-7 mg per 24 hours, metanephrines less than 1.6 mg per 24 hours, and norepinephrine plus epinephrine less than 100 mcg per 24 hours
- Urine drug screen - Including cannabis, amphetamine, hallucinogens, cocaine, opioids, benzodiazepines
- Blood studies - To screen for occult alcoholism
- Psychological testing - Minnesota Multiphasic Personality Inventory (MMPI) may provide insight into the likelihood of a somatoform disorder. (Negative MMPI studies should encourage further pursuit of a medical cause for the symptoms.)
Imaging Studies
- Imaging studies are not routinely used in diagnosing the somatoform disorders. However, functional MRI may be of use in the diagnosis of some conditions such as unexplained visual loss.
- Imaging studies may be helpful to rule out unexplained physical symptoms due to a medical disorder.
Procedures
- Avoid invasive diagnostic procedures and aggressive surgical assessment.
More on Somatoform Disorders |
| Overview: Somatoform Disorders |
Differential Diagnoses & Workup: Somatoform Disorders |
| Treatment & Medication: Somatoform Disorders |
| Follow-up: Somatoform Disorders |
| Multimedia: Somatoform Disorders |
| References |
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References
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Further Reading
Keywords
somatization, body dysmorphic disorder, conversion disorder, hypochondriasis, somatization disorder, somatoform disorder NOS, somatoform disorder not otherwise specified, unexplained physical symptoms
Differential Diagnoses & Workup: Somatoform Disorders