A medical inpatient who is being counseled for somatoform pain disorder states he believes his pain is the result of an undiagnosed injury.He adds that he is unable to adhere to his plan for care,which involves performing his own activities of daily living,walking 20 minutes daily,and using pain medication only at bedtime.Which behavior,as charted by staff,would most suggest that he is responding to interventions?

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Persons with somatoform pain disorder have pain which does not have a physical origin but instead is believed to be psychogenic in nature.Increased independent functioning and decreased use of analgesics suggests that the disorder is improving,as seen here in the note that the patient bathed himself and did not seek analgesics this shift.Being up ad lib and "trying not to use pain meds" presents a less clear picture so is not the most reliable indicator of progress.It is not clear,for example,whether in the end the patient did or did not use analgesics.Similarly,trying a non-narcotic does not necessarily indicate that he will no longer want the stronger medication.Seeking to leave the hospital might seem like an indicator of improvement,but sometimes persons with this disorder seek to terminate treatment when staff begin to suspect that there is no physiological cause of the pain.

A Medical Inpatient Who Is Being Counseled for Somatoform Pain