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Somatization disorder is a chronic condition in which there are numerous physical complaints - lasting for years and resulting in substantial impairment - that are caused by psychological problems and for which no underlying physical problem can be identified.
In medical clinics, the most commonly seen of the Somatoform disorders is Somatization Disorder. In the history of psychology, this was often referred to as "hysteria" or "Briquet’s Syndrome." It is characterized by multiple symptoms involving pain, gastrointestinal, sexual and pseudoneurological complaints. The complaints begin before age 30 and extend over many years. The patient often has a complex medical history of shopping for diagnoses and endless series of laboratory and radiologic studies.
Symptoms of Somatization Disorder
DSM-IV states that for a symptom to qualify for somatization disorder, it has to be without medical explanation. Some of the numerous symptoms that can occur with somatization disorder include:
- Abdominal pain
- Pain in the legs or arms
- Back pain
- Joint pain
- Pain during urination
- Shortness of breath
- Chest pain
- Difficulty swallowing
- Vision changes
- Paralysis or muscle weakness
- Sexual apathy
- Pain during intercourse
- Painful menstruation
- Irregular menstruation
- Excessive menstrual bleeding
Epidemiology of Somatization Disorder
The reports of prevalence of somatization disorder depend on the assessment methods used. Community surveys have reported prevalences of less than 1% and primary care findings have usually been between 1 and 2%. The disorder is twice as common in women than in men. There is substantial co-morbidity with other defined psychiatric disorders, such as major depression. Diagnosis is considerably less stable over time than suggested in the original descriptions of the syndrome.
Treatment of Somatization Disorder
Somatization disorder is difficult to treat. Continuing care by one doctor using only the minimum of essential investigations can reduce the patients' use of health services and may improve their functional state.
Once other causes have been ruled out and a diagnosis of somatization disorder is secured, the goal of treatment is to help the person learn to control the symptoms. There is often an underlying mood disorder which can respond to conventional treatment, such as antidepressant medications.
A supportive relationship with a sympathetic health care provider is the most important aspect of treatment. Regularly scheduled appointments should be maintained to review symptoms and the person's coping mechanisms. Test results should be explained.
Psychiatric assessment can help to clarify a complicated history, to negotiate a simplified pattern of care and to agree the aims of treatment with the patient, the family and the responsible physician. The aim of treatment is often to limit further progression rather than to cure.
It is not helpful to tell people with this disorder that their symptoms are imaginary.
Prevention of Somatization Disorder
Counseling or other psychological interventions may help people who are prone to somatization learn other ways of dealing with stresses. This may help reduce the intensity of the symptoms.