Somatization disorder

Definition:
Multiple physical complaints that suggest physical disorders without a disease or physical basis to account for them.

Alternative Names:
Briquet's syndrome

Causes, incidence, and risk factors:

In somatization disorders, there tends to be a pattern of multiple and recurrent symptoms and complaints that can involve any body system and often persist for years. Most frequently, the complaints involve the gastrointestinal system, the nervous system, the cardiopulmonary (heart and lungs) system, or the reproductive system. The symptoms begin before the age of 30 and occur more often in females.

The symptoms are severe enough to lead to the person to visit the doctor or take medication, and may interfere with the person's life. The cause is not specific but symptoms begin or worsen after losing a job, close relative, or friend, or other loss. A lifelong history of sickliness is often present, and often people with this disorder relate to others only through their symptoms. A greater intensity of symptoms often occurs with stress.



Symptoms:
Note: A variety of symptoms may be present at any given time.

Signs and tests:
  • Physical examination and limited diagnostic tests to rule out physical causes
  • Psychological evaluation to rule out related disorders


Treatment:

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.

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. Acknowledgment and explanation of test results should occur. It is not helpful to tell people with this disorder that their symptoms are imaginary.



Expectations (prognosis):

People with a somatization disorder rarely acknowledge that their illness has a psychological component and will usually reject psychiatric treatment.



Complications:

There is a possibility that a real disease may be overlooked by their health care provider in people with a somatization disorder because of a previous history of unfounded complaints.

Complications may result from invasive testing and multiple evaluations looking for the cause of the symptoms.

A dependency on pain relievers or sedatives may develop.

A poor relationship with the health care provider seems to worsen the condition, as does evaluation by many providers.



Calling your health care provider:

A good relationship with a consistent primary health care provider is helpful. Call for an appointment if there is a significant change in symptoms. Ordinarily, people with somatization disorder see their doctor much more frequently than the rest of the population.



Prevention:

Counseling or other psychological intervention may help people who are prone to somatization to learn other ways of dealing with stresses. This may help reduce the intensity of symptoms.




Review Date: 5/18/2001
Reviewed By: Christos Ballas, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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