DSM-IV-TR Casebook Diagnosis of "The Suffering Lady"
Although Somatization Disorder (see DSM-IV-TR) was a new
diagnostic category in DSM-III, this nineteenth-century case is
a classic example of the disorder. There is a history of many physical
symptoms and complaints, not adequately explained by a physical
disorder or injury, that go back to the patient's adolescence.
The DSM-IV-TR criteria for the disorder require unexplained symptoms
in four areas: pain (four symptoms), gastrointestinal (two symptoms),
sexual/reproductive (one symptom), and pseudoneurologic
(one symptom). There are many references to multiple vague pain
and gastrointestinal symptoms. She has had many pseudoneurologic
(conversion) symptoms: loss of voice, seizures, trouble walking,
and muscle weakness. There is reference to "disturbances
of menstruation." As is commonly the case, genuine physical
problems coexist but are hardly adequate to explain the myriad physical