Somatization disorder

Overview

Somatization, or the physical manifestation of psychological anguish, affects a high number of primary care patients. It is linked to significant distress and disability, as well as increased health-care consumption. Some somatizing individuals have a history of several unexplained complaints (somatization disorder), while others are overly concerned about serious disease (hypochondriasis), and still others have mental problems that manifest as somatic symptoms (depression and anxiety).

Somatizing patients, in general, exhibit atypical sickness behavior (e.g., failure to react to therapy, excessive consumption of care) as well as psychological distress (eg, depressive symptoms, psychosocial stressors). Recognition necessitates a keen eye for distinguishing characteristics as well as a deft interview style. The first step toward effective management is to legitimize symptoms. Restraint should be exercised while completing workups on somatizing individuals and giving diagnoses.

Treatment objectives should be defined, and frequent appointments should be organized. In addition, behaviors that endanger the physician-patient relationship must be addressed. When depression and anxiety are present, they should be addressed. There have been descriptions of pharmacologic and psychosocial therapies for somatizing patients, but none have been demonstrated to be effective.