Somatization disorder
When multiple recurrent signs and symptoms of several years’ duration suggest that physical disorders exist without a verifiable disease or pathophysiologic condition to account for them, somatization disorder is present.
The typical patient with somatization disorder usually undergoes repeated medical examinations and diagnostic
testing that—unlike the symptoms themselves—can be potentially dangerous or debilitating. However, unlike the hypochondriac, she isn’t preoccupied with the belief that she has a specific disease.
testing that—unlike the symptoms themselves—can be potentially dangerous or debilitating. However, unlike the hypochondriac, she isn’t preoccupied with the belief that she has a specific disease.
Somatization disorder usually is chronic, with exacerbations during times of stress.
Clinical TipThe patient’s signs and symptoms are involuntary, and she consciously wants to feel better. Nonetheless, she’s seldom entirely symptom-free.
Signs and symptoms usually begin in adolescence; rarely, when the patient is in her 20s. This disorder primarily affects women; it’s seldom diagnosed in men.
Causes
Both genetic and environmental factors contribute to the development of somatization disorder.
Signs and symptoms
A patient with somatization disorder presents physical complaints in a dramatic, vague, or exaggerated way, often as part of a complicated medical history in which many medical diagnoses have been considered.
An important clue to this disorder is a history of multiple medical evaluations by different physicians at different institutions—sometimes simultaneously—without significant findings. The patient usually appears anxious and depressed.
Common physical complaints include:
conversion or pseudoneurologic signs and symptoms (for example, paralysis or blindness)
GI discomfort (abdominal pain, nausea, or vomiting)
female reproductive difficulties (such as painful menstruation) or male reproductive difficulties (such as erectile dysfunction)
psychosexual problems (such as sexual indifference)
chronic pain (such as back pain)
cardiopulmonary symptoms (chest pain, dizziness, or palpitations).
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