INTRODUCTION:

The Somatoform Disorders are a group of problems in which people suffer from somatic symptoms or worry about bodily illness or deformity that cannot be accounted for by an organic medical condition or another psychiatric disorder such as depression or anxiety¹. While ‘psychosomatic diseases’ are no longer recognized as distinct disorders since psychological and behavioral factors may affect any medical condition the somatoform disorders retain the implication of being wholly or predominantly caused by psychological processes that influence symptom perception and illness behavior.²

As we shall see, in some cases this presumption may be unwarranted. The somatoform disorders are a group of psychiatric disorders in which patients present with a myriad of clinically significant but unexplained physical symptoms. They include somatization disorder, undifferentiated somatoform disorder, hypochondriasis, conversion disorder, pain disorder, body dysmorphic disorder, and somatoform disorder not otherwise specified. The Somatic Symptom and Related Disorders (SSRD) section was particularly controversial because it proposed major changes by de-emphasizing the centrality of medically unexplained symptoms. In making a diagnosis of Somatic Symptom and Related Disorders, DSM5 considers instead longstanding somatic symptoms that are associated with disproportionate thoughts, feelings, and behaviors.³

These disorders often cause significant emotional distress for patients and are a challenge to family physicians. Up to 50 percent of primary care patients present with physical symptoms that cannot be explained by a general medical condition. Some of these patients meet criteria for somatoform disorders^.This decision was made for a number of reasons.⁴Medically unexplained symptoms are all too often dismissed as not authentic even though the relationship between structural severity of illness and subjective symptom report is notoriously weak throughout medicine. Similarly, while today’s symptom may be regarded as “unexplained,” it could just as well be “not yet recognized.” How somatic symptoms are experienced and communicated is at the marrow of psychosomatic medicine, whether the symptom pathophysiology is crystal clear or opaque. The journal has continued to publish groundbreaking research in this area (see for example the editorial perspective by Barsky and the work by Maunder et al).⁵

Although most do not meet the strict psychiatric diagnostic criteria for one of the somatoform disorders, they can be referred to as having “somatic preoccupation,” a subthreshold presentation of somatoform disorders that can also cause patients distress and require intervention.⁶ The unexplained symptoms of somatoform disorders often lead to general health anxiety; frequent or recurrent and excessive preoccupation with unexplained physical symptoms; inaccurate or exaggerated beliefs about somatic symptoms; difficult encounters with the health care system; disproportionate disability; displays of strong, often negative emotions toward the physician or office staff; unrealistic expectations; and, occasionally, resistance to or noncompliance with diagnostic or treatment efforts. These behaviors may result in more frequent office visits, unnecessary laboratory or imaging tests, or costly and potentially dangerous invasive procedures.⁷

Disorders such as somatic symptom disorder and illness anxiety disorder are distressing to patients, their families, and their physicians. They are also common and have porous borders with anxiety and depression. Participants in the work group that designed the somatic symptom disorder criteria laid out a series of research challenges that the diagnosis would need to address in the future.

NEED OF THE STUDY

Somatoform disorders have been recognized from a long time and originally referred to as Briquet syndrome in honor of Paul Briquet, a French physician who first described the disorder in the nineteenth century. The term somatization has been used to refer to variety of clinical features. A traditional view defines somatization as an inability or unwillingness to express emotional distress. According to an alternative view defines somatization as the presentation of somatic complaints in the presence of an anxiety or depressive disorder. A third view defines somatization as the reporting of physical complaints which have no clear medical explanation. While these three perspectives appear closely related, they refer to different groups of patients. Consequently, in the ICD and DSM classification systems somatization disorders are defined as a chronic condition characterized by the reporting of numerous unexplained somatic symptoms. Recent versions of both classification systems have attempted to identify the core syndrome of somatization (a persistent tendency to report multiple unexplained somatic symptoms) using a simplified set of diagnostic criteria. Somatoform disorders constitute a group of illnesses that present with predominant physical symptoms for which there is no demonstrable etiology, and psychological factors are implicated in initiating, exacerbating, and maintaining the disorder.

More recently, other categories of disorders presenting with somatic symptoms have been identified. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) has seven subtypes of somatoform disorders, namely somatization disorder, conversion disorder, pain disorder, hypochondriasis, body dysmorphic disorder, undifferentiated somatoform disorder, and somatoform disorder not otherwise specified. International Classification of Diseases, Tenth Revision (ICD-10) as a reference on the other hand describes seven major categories, namely somatization disorder, undifferentiated somatoform disorder, hypochondriacal disorder, somatoform autonomic dysfunction, persistent pain disorder, other somatoform disorders, and somatoform disorder unspecified. In ICD-10, conversion disorder has been described as a dissociative disorder, in a separate category. The prevalence of somatization disorder in the general population is estimated to be 0.2%-2% in females and 0.2% in males.

The prevalence of functional somatic syndromes (FSS) in primary care is estimated at 26 to 35%, as shown by a systematic review including 32 studies from 24 countries. Moreover, patients with FSS often have psychic comorbidity in the form of increased depression or anxiety. In many cases the high levels of mental and physical distress lead patients to consult numerous different physicians. This leads ultimately to major challenges for medical practitioners of all specialties, because as a general rule further diagnostic investigation is demanded for allegedly definitive exclusion of organic diseases. Accordingly, the impact on high healthcare utilization is well documented. Studies from (tertiary) inpatient settings have, in isolated cases, shown that as a consequence of such help-seeking behavior, patients with FSS undergo more frequent diagnostic examinations and perhaps also more surgical procedures, which are not only expensive but also potentially harmful. However, the impact of somatization disorders on healthcare utilization with respect to potentially harmful investigations in ambulatory care is still unclear.

OBJECTIVE:

· To assess existing knowledge regarding prevention and management of somatoform disorder, among art’s college students in selected college of Rajkot.

· To assess the effectiveness of the planned teaching programme regarding prevention and management among art’s college students in selected college of Rajkot.

· To find out the association between pretest knowledge scores with the selected socio-demographic variables regarding prevention and management somatoform disorder among art’s college students of selected college of Rajkot.

HYPOTHESIS OF THE STUDY:

· H₁: There will be a significant difference between the pre-test knowledge score and posttest knowledge score related to prevention and management of somatoform disorder.

· H₂: There will be a significant association between pretest knowledge score and selected demographic variable at a 0.05 level of significance.

METHODOLOGY:

RESEARCH APPEOACH

Quantitative research approach

RESEARCH DESIGN:

Pre-experimental, one group pre-test and post-test design.

POPULATION

• Target population: Target population for present study is Art’s students.

• Accessible population: Accessible population is Art’s students in selected college of Rajkot.

SAMPLE: The population of the study consist of Art’s students from college at Rajkot.

SAMPLE SIZE

The sample size of the study was 60 art students who study in selected college of Rajkot.

SAMPLING TECHNIQUE

Convenience nonprobability sampling technique.

CRITERIA FOR SAMPLING TECHNIQUE

INCLUSION CRITERIA

· Students who will available at the time of data collection.

· Students who will willing to participate in the study.

· Students who read and understand English and Gujarati.

EXCLUSION CRITERIA

· Students who are not willing to participate in the study.

· Students who are not available at the time of data collection.

· Students who cannot read and understand Gujarati and English.

DATA ANALYSIS PLAN

The collected data was analyzed using both descriptive and inferential statistics.

RESULTS:

Major study findings includes.

Findings related to demographic variables of the study

1. The majority of 25(48%) the samples age is between 21-25years.

2. The majority of 38(40%) the samples are belonged to male.

3. The majority of 55(63%) the samples are belonged from Hindu.

4. The majority of 44(80%) the samples are unmarried.

5. The majority of 47(78.33%) the samples have no family history of somatoform disorder.

6. The majority of55 (91.67%) the samples are belonged to rural area.

7. The majority of 35(58.33%) the samples had information gain from health care team.

The effectiveness of planned teaching programme on knowledge regarding prevention and management of somatoform disorders was revealed in the post-test that there was significance improvement in knowledge with administration of planned teaching programmme. The obtained “t-test” value for the level of knowledge on prevention and management of selected breast complication 17.345 that was highly significance at p<0.05 level the hypothesis was accepted.

The analysis report of the table explains that demographic variables such Age, Gender, Marital status, Family history and Source of information, has obtained X²value below the level of tabulated value at level of 0.05. Other demographical variables such Residence, Religion has obtained X²value above the level of tabulation at the level of 0.05. thus, hypothesis H2 is accepted. So, it is inferred that there is association between the pre-test level of knowledge with their selected demographic variables.

CONCLUSION:

Somatoform disorders have been more often than was assumed in past the main conclusion from this present study is that the most of the arts student’s studies in selected college had inadequate and moderate level of knowledge in pre-test and adequate and moderate knowledge in post-test. Arts students shown improved knowledge after panned teaching programme on knowledge regarding prevention and management of somatoform disorders and it will improve the quality of health regarding prevention and management of somatoform disorders.

REFERENCES:

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Rev. Washington, D.C. American Psychiatric Association, 2000.

2. Barsky AJ, Borus JF. Somatization and medicalization in the era of managed care. JAMA. 1995; 274: 1931-4.

3. Maunder R, Hunter J, Atkinson L, Steiner M, Wazana A, Fleming A, Moss E, Gaudreau H, Meaney M, Levitan R. An Attachment-Based Model of the Relationship Between Childhood Adversity and Somatization in Children and Adults. Psychosom Med. 2017; 79: 506–513.

4. de Waal MW, Arnold IA, Eekhof JA, van Hemert AM. Somatoform disorders in general practice: prevalence, functional impairment and comorbidity with anxiety and depressive disorders. Br J Psychiatry. 2004; 184: 470-6.

5. Righter EL, Sansone RA. Managing somatic preoccupation. Am Fam Physician. 1999; 59: 3113-20.

6. Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry. 2005; 62: 903-10.

7. Hiller W, Fichter MM, Rief W. A controlled treatment study of somatoform disorders including analysis of healthcare utilization and cost-effectiveness. J Psychosom Res. 2003; 54: 369-80.

Received on 16.02.2024 Modified on 08.03.2024

Int. J. of Advances in Nur. Management. 2024; 12(2):77-80.

DOI: 10.52711/2454-2652.2024.00017