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Somatoform and imitation disorders: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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Somatization is the manifestation of mental phenomena through physical (somatic) symptoms. Usually, these symptoms cannot be explained by a somatic disease. Disorders are characterized by somatization, which manifests itself as a continuum from symptoms that develop unconsciously and involuntarily to symptoms that develop consciously and intentionally. This continuum includes somatoform disorders, factitious disorders, and malingering. Somatization is fraught with a series of regular medical examinations and a constant search for treatment.
Somatoform disorders are characterized by physical symptoms or perceptions of defects in one's appearance. The development of symptoms or perceptions of defects occurs unconsciously and involuntarily. The symptoms or perceptions of defects cannot be explained by an underlying physical illness. Somatoform disorders cause distress and often impair social, occupational, and other functioning. These disorders include body dysmorphic disorder, conversion disorder, hypochondriasis, pain disorder, somatization disorder, undifferentiated somatoform disorder, and somatoform disorder not elsewhere classified.
Factitious disorders involve the conscious and deliberate presentation of false symptoms in the absence of any external stimuli and specific life goals (e.g., finishing work on time) and are thus distinguished from aggravation. The patient derives reward from assuming the sick role by simulating, exaggerating, or aggravating signs and symptoms. The signs and symptoms may be mental, physical, or both. The most severe form is Munchausen syndrome.
Aggravation is the repeated, persistent presentation of false physical and mental symptoms motivated by external factors (e.g., feigning illness to avoid work or military service, to evade prosecution, to obtain financial compensation, or to abuse drugs). Aggravation may be suspected when a patient reports severe symptoms that are not readily apparent from objective observation, physical examination, or laboratory testing. Aggravation may also be suspected when a patient is uncooperative in attempts to diagnose or treat a potential cause of his or her symptoms.
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