Somatization disorder

Abstract

Somatization disorder (SD) is a syndromatic classification that allows a physician to identify more easily patients with a lifelong history of chronic subjective physical complaints that are unverified by objective examinations either at the time of initial presentation or during the subsequent five years. The somaticizing process is believed to be an expression of emotional distress. The most common complaints of SD patients include recurrent pain (site and quality vary), conversion (pseudoneurologic) symptoms, nervousness or depression (or both), sexual and marital discord, and, often, menstrual difficulties. Such patients will generally have a history of repeated hospitalization or surgery. These symptoms are not perceived as mild or unimportant but lead to physician consultation, prescription drug use, and modification of life-style. Such patients are prone to "doctor-shopping" and self-medication and are at risk for many iatrogenic illnesses. Because they generally are resistant to psychologic explanations for their condition, management aimed at protecting them from the consequences of their behavior is important. A heightened threshold for instituting aggressive diagnostic and treatment procedures is necessary.