Functional disorders manifest as physical discomfort without identifiable organic disease, affecting daily life and often linked to psychological causes. Symptoms can include headaches, fatigue, and various pains, with risk factors including stressful life events and potential genetic predisposition. Treatment options range from cognitive behavioral therapy to medication, aiming to improve patients' quality of life despite the challenges these disorders present.

1. Functional disorders
M.Haseeb Ashraf

2. What is a functional disorder?
• A functional disorder causes physical discomfort which
makes everyday life difficult. It can be seen as a disorder
where the mind and the body for various reasons are not
functioning properly.
• This term is used because the person has a disturbance
of their functioning that arises in the absence of any
disease.

3. Functional Symptoms vs. Organic
Disease
Functional Symptoms
• No possible finding of
organic or pathological
tissue changes while
physician investigating,
psychological causes.
• headaches, fatigue,
insomnia, irritability,
abdominal pain, indigestion,
low back pain, or simply not
feeling well.
Organic symptoms
• physical, cellular
changes that can be
identified by diagnostic
testing
• cancer, arthritis, heart
disease, gastric ulcers,
and emphysema.

4. Are functional disorders
common?
• Yes. Somewhere between 20% and 40%
of people attending almost any hospital
clinic have symptoms
• sometimes disabilities for which there is
no specific explanation.
• The doctors cannot find evidence for any
disease, or other damage to account for
the symptoms.

5. Why is it called a ‘functional
disorder’?
• Many different names have been used.
• the preferred name is "a functional
disorder".
• This term is used because the person has
a disturbance of their functioning that
arises in the absence of any disease.
• The person’s function is disordered.

6. The following names have been
used.
• somatization, somatoform disorder
• hysteria, hysterical disorder, conversion disorder
• non-organic symptoms, non-organic illness, medically
unexplained symptoms
• stress-related symptoms, anxiety, atypical depression.
• Many other names have been used.

7. Some examples of functional
disorders are
• Conversion disorder
• Somatization disorder
• Hypochondriasis
• Body dysmorphic disorder
• Pain disorder
• Dissociative amnesia
• Dissociative fugue
• Depersonalization disorder
• Dissociative identity disorder

8. Some risk factors for
functional disorder.
• a stressful childhood, with such things as abuse, being
orphaned, and losing a parent
• Experience of a severe unusual stress, such as
exposure to a very nasty accident
• Ongoing high stresses in life, such as an unsatisfactory
job, problems at home, financial worries.

9. The common symptoms are:
Symptoms from heart
and lungs
• Palpitations
• Chest pain
• Short of breath without
exertion
• Cold or hot sweats
• Shaking or trembling
• Mouth dryness
• 'Butterflies' or abdominal
churning
Symptoms from stomach
and intestines
• Frequent loose stools
• Abdominal pain
• Bloated stomach
• Abdominal tension or weight
sensation
• Diarrhea
• Vomiting
• Constipation
• Nausea
• Burning sensation in the chest or
upper abdominal area

10. Con……
Symptoms from the
muscles
• Pain in the arms or legs
• Muscular ache or pain
• Pain in the joints
(arthralgia)
• Feeling of paresis or
localized weakness
• Backache
• Pain moving from one
place to another
• Unpleasant numbness or
tingling sensations
General symptoms
• Concentration difficulties
• Fatigue
• Headache
• Impairment of memory
• Dizziness

11. Among research scientists and
practitioners there is a general consensus
that:
• the cause of functional disorders is multi-factorial,
• the brain plays a part in a functional disorder. Scans
have showed changes in the way the brain reacts
when the body is inflicted with pain.
• functional disorders are often caused by a combination
of congenital vulnerability and strain and stress.
• functional disorders can be treated with cognitive
behavioural therapy and graded exercise therapy.
Some patients will benefit from medicinal treatment,
primarily from anti-depressant pills.

12. Con…
• a functional disorder is a real disease.
• the patients are not ‘pretending’ to be ill, and they are not
patients who lie, cheat or exaggerate to gain social
benefits.
• Research shows that many patients can recover. Most of
them can get a significantly better quality of life.
However, some of them will have to keep showing
consideration for their body and learn to live with the
functional disorder, the same way that one can learn to
live with other chronic diseases such as asthma or
diabetes.

13. Functional disorders are challenging
• Functional disorders challenge our usual
way of thinking that an illness is either
purely physical, psychological, social or
something else.
• To understand functional disorders it is
necessary to look at the body, the mind and
society as factors affecting each other and
which all can be the cause of an illness.

14. Somatoform disorders & types
• Subjective experience of many physical symptoms with
no organic cause
• Types
• Conversion disorder
• Somatization disorder
• Hypochondriasis
• Body dysmorphic disorder
• Pain disorder

15. Conversion disorder
Loss of functioning in the part of
the body for psychological rather
than the physical reason
• Paralysis
• Blindness
• Mutism
• Seizure
• Hearing loss
• Sever loss of
coordination
• Anesthesia in limb
Somatization disorder
Is a diagnoses when individuals have a
history of numerous physical complains
for which no medical causes can be found
• Pain symptoms(Head ,
Back, Rectum, pain
Legs)
• Gastrointestinal(nausea,
diarrhea)
• Sexual disturbance
• Neurological
symptoms(paralysis,
double vision, deafness)

16. Hypochondriasis
Chronic worry that one has physical
disease in the absence of evidence that
one does and frequent seeking of medical
attention
• For example, that a
minor headache may be
caused by a brain
tumour, or a mild rash is
the start of skin cancer
Body dysmorphic disorder
Excessive preoccupation with the part of
the body the person believes is defective
• Headache
• Pain in the back,
muscles, joints
• Stomach problems
• Shortness of breath
• Fatigue

17. Video of conversion and Body dysmorphic
disorder

18. Pain disorder
• Pain disorder is a condition where a
person has a persistent pain that cannot
be attributed to a physical disorder

19. Dissociative disorders
• are conditions that involve disruptions or breakdowns of memory,
awareness, identity, or perception. People with dissociative
disorders use dissociation, a defense mechanism, pathologically
and involuntarily. Dissociative disorders are thought to primarily be
caused by psychological trauma.
• Types
• Dissociative amnesia
• Dissociative fugue
• Depersonalization disorder
• Dissociative identity disorder

20. Dissociative identity disorder
There are separate, multipule personalities in
same individual. The personalities also may be
aware of each other or may have amnesia for
each other
• Discontinuity in sense of
self and sense of agency
• Alteration in behavior
consciousness, memory,
perception, cognition,
sensory motor function.
• Recurrent gap in recall
every day events,
important personal
information and traumatic
events
Dissociative amnesia
Loss of memory for important
facts about a person own life
and personal identity
• Amnesia can be
psychogenic or organic

21. Dissociative fugue
• Disorder in which a person moves away
and assumes a new identity with amnesia
for the pervious identity

22. Depersonalization disorder
• The presence of persistence are recurrent experience of
depersonalization, derealization or both
• Depersonalization: experience of unreality, detachment
or being an outside observer with respect to one
thoughts, feelings, sensation, body, or actions for e.g
perceptual alteration, distorted sense of time emotional
or physical numbing,
• Derealization: experience of unreality, detachment with
respect to surroundings for e.g individuals or objects are
experienced as unreal dream like foggy, life less, or
visual distorted.

23. CAUSES
No single cause several factors contribute
• Some people are congenitally vulnerable.(genes)
• Some people develop a functional disorder after great or
long-term stress, e.g. (a divorce, illness in the family or
social problems.)
• Sometimes an infectious disease or an accident cause
the development of a functional disorder.

24. HEREDITY
Heredity is closely connected to functional disorders.
• Genetic heredity
• The probability is stronger
among to develop a functional
disorder in identical twins.
• This probability is weaker
among fraternal twins.
• Social heredity
• that stressful social
circumstances may worsen a
functional disorder.
• Highly Complexity
• You do not inherit a functional
disorder the same way you
inherit e.g. blue eyes or black
hair. On the other hand.
• if you experience one or
several stressful events, you
will have a stronger proneness
to develop a functional
disorder.
• In certain families, Some
people developed a functional
disorder already in early
childhood without the presence
of any stressful events.

25. Role of Hormones
• A state of alertness is caused by an activation of the so-
called autonomic nervous system and the release of
a large amount of stress hormones, e.g. cortisol and
noradrenalin.
• The stress hormones cause a production of a number of
physical symptoms.
• Many of the symptoms related to stress are the same
symptoms we experience in connection with a functional
disorder.

26. Treatment of Functional Disorder

27. Types Of Functional Disorder
There are following two types
Dissociative Disorder
Somatoform Disorder

28. Method Of Treatment
• Psychotherapy
psychological methods to treat
mental or emotional problems, eg to help
patients to develop coping strategies.
• Pharmacotherapy
is therapy using pharmaceutical
drugs

29. Psychotherapies
• Psychodynamic Approach
• Hypnotic Therapy
• Group Therapy
• Cognitive Behavior Therapy
• Expressive Therapy
• Behavior Therapy

30. Psychodynamic Approach
• Psychodynamic therapists guide patients
to their unconscious and bring forgotten
experiences into consciousness
• Psychoanalysts seek to help people with
dissociative identity disorder uncover and
learn to cope with early childhood
traumas. They often recommend
establishing direct contact with alter
personalities (Burton & Lane, 2001).

31. Hypnotherapy
• In hypnotic therapy, patients are hypnotized
and guided to recall forgotten events
• Therapist training in hypnosis is highly useful
in the treatment of trauma and dissociation,
especially DID.
• It gives the therapist a broader awareness of
the patient’s experiences as well as powerful
techniques that can benefit the patient.
• Formal induction is not usually needed on a
regular basis.

32. Cognitive Behavior Therapy
• A cognitive behavior therapy that
incorporates mindfulness and a series of
exercises to help the patient decrease
trigger responses to internal and external
stimuli. Helps with self-soothing.
• distorted thoughts
• unrealistic beliefs
• behaviors that prompt health anxiety

33. Group therapy
• DID in groups can be problematic.
• Agreements need to be made about
control of child alters during sessions.
• Therapists have to be careful not to
prematurely expose trauma to group.
• Ongoing individual psychotherapy is
needed to support the group process.

34. Expressive therapies
• May be very useful to allow the patient to
spill the feelings without the cognitive self-
judgment that may accompany “talk
therapy”.

35. Pharmacotherapy
• Nearly all classes of psychotropic
medications have been used empirically
with DID patients.
• Antidepressants: SSRIs treat
depression/PTSD
• Anxolytics: Short term for anxiety
.

36. Pharmacotherapy
• Neuroleptic/antipsychotics: Treat
overactivation; thought disorganization;
intrusive PTSD symptoms; chronic
anxiety; insomnia; irritability
• Opioid antagonist, naltrexone, decreases
some depersonalization disorder
symptoms

37. THANKS..