A Somatic Disease or Somatoform Disorder? A Case Report of A 40-Year-Old Female with Abdominal Pain and Episodes of Presyncope

Somatoform disorders are characterized by physical symptoms with no identifiable medical explanation. We present a case of a 40-year-old female with abdominal pain and weight loss, who was admitted for endoscopic examination of the gastrointestinal tract. She reported intense pain in the abdomen, but her affect display was restricted. During physical examination, an episode of presyncope occurred. During the episode the patient remained normotensive and normoglycemic, her electrocardiogram was clear. She admitted to having similar episodes for over 7 years. The patient underwent broad diagnostics, including computed tomography of the head and the abdomen, Doppler ultrasound of carotid arteries, magnetic resonance of the brain, electroencephalogram and others. The patient was also evaluated by doctors of various specialties: endocrinology, neurology, cardiology, and ophthalmology, neither of whom was able to explain the nature of the symptoms. Eventually, the patient was consulted by a psychiatrist, who diagnosed her with somatoform disorders and advised further treatment and diagnosis in a mental health clinic. She was also referred to a cardiologist and neurologist to continue treatment in an outpatient setting. Further investigation might help confirm the psychiatric diagnosis but can also undermine it. Keywords: somatoform disorders, presyncope, diagnosis