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's not preoccupied with the belief that she has a specific disease.
Somatization disorder usually is chronic, with exacerbations during times of stress.
CausesBoth genetic and environmental factors contribute to the development of somatization disorder.
Signs and symptoms
Some of the numerous symptoms that can occur with somatization disorder include:
Diagnostic tests rule out physical disorders that cause vague and confusing symptoms, such as hyperparathyroidism, porphyria, multiple sclerosis, and systemic lupus erythematosus. In addition, multiple physical signs and symptoms that appear for the first time late in life usually stem from physical disease, rather than somatization disorder.
The goal of treatment is to help the patient learn to live with her signs and symptoms. After diagnostic evaluation has ruled out organic causes, the patient should be told that she has no serious illness currently but will receive care for her genuine distress and ongoing medical attention for her symptoms.
The most important aspect of treatment is a continuing supportive relationship with a health care provider who acknowledges the patient's signs and symptoms and is willing to help her live with them. The patient should have regularly scheduled appointments to review her complaints and the effectiveness of her coping strategies.
The patient with somatization disorder seldom acknowledges any psychological aspect of her illness and rejects psychiatric treatment.
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.
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