Definition
This occurs when a HA is part of the symptomatic presentation of a somatization disorder. Somatization disorder is a combination of distressing symptoms and an excessive or maladaptive response to these symptoms or associated health issues.
Signs & symptoms
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Diagnostic Criteria
A. Any headache fulfilling criterion C
B. A diagnosis has been made of somatization disorder characterized by both of the following:
1) A history of multiple physical symptoms beginning before age 30 years, which either have not been fully explained by a known medical condition or, when there is a related medical condition, are in excess of what would be expected from the history, physical examination, or laboratory findings
2) During the course of the disorder, all of the following:
a) At least four pain symptoms from or during four different sites or functions (e.g. from head, chest, back, abdomen, joints, extremities and/or rectum, and/or during menstruation, sexual intercourse and/or urination)
b) At least two gastrointestinal symptoms other than pain (e.g. nausea, bloating, vomiting other than during pregnancy, diarrhea and/ or intolerance of several different foods)
c) At least one sexual symptom other than pain (e.g. sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding and/or vomiting throughout pregnancy)
d) At least one pseudoneurological symptom not limited to pain (e.g. conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in the throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blind- ness, deafness, seizures, dissociation symptoms such as amnesia and/or loss of consciousness other than fainting)
C. Evidence of causation demonstrated by at least one of the following:
1. Headache has evolved or significantly worsened in intensity in parallel with the development of other somatic symptoms attributed to somatization disorder
2. Constant or remitting headache parallels in time the fluctuation of other somatic symptoms attributed to somatization disorder
3. Headache has remitted in parallel with remission of the other somatic symptoms attributed to somatization disorder
D. Not better accounted for by another ICHD-3 diagnosis
B. A diagnosis has been made of somatization disorder characterized by both of the following:
1) A history of multiple physical symptoms beginning before age 30 years, which either have not been fully explained by a known medical condition or, when there is a related medical condition, are in excess of what would be expected from the history, physical examination, or laboratory findings
2) During the course of the disorder, all of the following:
a) At least four pain symptoms from or during four different sites or functions (e.g. from head, chest, back, abdomen, joints, extremities and/or rectum, and/or during menstruation, sexual intercourse and/or urination)
b) At least two gastrointestinal symptoms other than pain (e.g. nausea, bloating, vomiting other than during pregnancy, diarrhea and/ or intolerance of several different foods)
c) At least one sexual symptom other than pain (e.g. sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding and/or vomiting throughout pregnancy)
d) At least one pseudoneurological symptom not limited to pain (e.g. conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in the throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blind- ness, deafness, seizures, dissociation symptoms such as amnesia and/or loss of consciousness other than fainting)
C. Evidence of causation demonstrated by at least one of the following:
1. Headache has evolved or significantly worsened in intensity in parallel with the development of other somatic symptoms attributed to somatization disorder
2. Constant or remitting headache parallels in time the fluctuation of other somatic symptoms attributed to somatization disorder
3. Headache has remitted in parallel with remission of the other somatic symptoms attributed to somatization disorder
D. Not better accounted for by another ICHD-3 diagnosis
References:
- Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629-808.
Kyle Kibler, SPT, CSCS
A.T. Still University
Arizona School of Health Science
Physical Therapy Program
Published: July 13, 2015
A.T. Still University
Arizona School of Health Science
Physical Therapy Program
Published: July 13, 2015