Conflicts or other stressors that precede the onset or worsening of this symptom suggest that psychological factors are related to it. It is not a culturally sanctioned behavior or experience. It does not occur solely during Somatization Disorder, and no other mental disorder better explains it. Examples are trouble swallowing, frequent belching, spells of coughing or vomiting, all carried to an uncommon extreme. In both sensory and motor symptoms, the areas affected may not correspond at all to the nerve distribution in the area.
Some disorders have similar or even the same symptom.
The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which he needs to rule out to establish a precise diagnosis. These disorders may be best thought of as disturbances of illness perception or need. They are paradigms of mind-body interactions and of the critical role of mental factors in the production of illness. Though the role of the mind in creating and maintaining illness has been known since antiquity, terms such as hysteria or psychosomatic illness have lost their meaning over time. A physical examination is performed to rule out physical cause for loss of function.