Somatization Disorder
all information

Somatization Disorder

(SD; Briquet’s Syndrome)

Pronounced: so-mah-ti-za-shon dis-order

En Español (Spanish Version)

Definition

Individuals with somatization disorder claim to suffer constantly and for many years from many physical illnesses, yet they do not have any specific, diagnosed medical illnesses that can explain their symptoms. Still, these symptoms cause distress and negatively affect the individual’s ability to function day-to-day.

If you suspect you have this condition, contact your doctor for further evaluation.

Causes

The cause of somatization disorder is not known.

There is no medical illness to explain the symptoms, and so the disorder is believed to be due to mental and emotional (aka psychological) causes. Often, symptoms seem to begin or get worse during stressful circumstances or in relation to emotional suffering (eg, loss of a friend, stress at work). It is as if these stressful life situations are experienced physically.

Researchers believe these components also may play a role in the disorder:

  • Genetics—it may run in your family
  • Psychosocial—it may be due to a combination of factors that include your mental and emotional well-being and your environment or situation

Risk Factors

The physical suffering that people with somatization disorder experience usually begins in the late 20s, but it can also begin during the teenage years. Individuals suffer for years and it often leads to many unnecessary medical tests and treatments.

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing somatization disorder:

  • Low social class with little education
  • Sex–the disorder is more common in American women, although it is more common in men of non-American cultures (Greek, Puerto Rican)
  • Personality factors–individuals are more likely to develop this disorder if they tend to act in a way that is extremely emotional (also known histrionic)
  • Individuals with antisocial personality disorder , substance abuse disorders, anxiety , depression , or panic disorders
  • May occur more frequently in individuals who are unable to express their emotional distress through language (due to neurological disorders or mental retardation ), or in cultures that discourage the communication of emotional distress

Symptoms

People with somatization disorder complain about many physical illnesses that involve many different parts of their body. A diagnosis of somatization disorder requires experiencing an assortment of symptoms (at least three) for a considerable amount of time (causing suffering for at least two years).

The symptoms include:

  • Pain symptoms—these include pain experienced in any part of the body including:
    • Headaches
    • Back pain
    • Joint pain
    • Chest pain
    • Irregular heartbeats
    • Pain in arms or legs
    • Pain in vagina or penis during sexual intercourse
    • Pain during urination
  • Gastrointestinal symptoms—these include any problem, other than pain, in the stomach or intestines, including:
    • Nausea
    • Bloating
    • Vomiting
    • Diarrhea
  • Sexual symptoms—these include any problem, other than pain, in the sexual or reproduction system, including:
    • Inability to sustain an erection (men)
    • Irregular periods (women)
    • Excessive menstrual bleeding (women)
  • Neurological symptoms—these include:
    • Being off-balance
    • Paralysis
    • Weakness
    • Trouble swallowing
    • Loss of voice
    • Inability to control the need to urinate
    • Delusions or hallucinations
    • Loss of touch
    • Unable to feel pain
    • Amnesia (loss of memory)
    • Temporary blindness
    • Temporary deafness
    • Seizures

    Nervous System

    Nervous system posterior 3D

    An emotional event may trigger physical symptoms, sometimes through peripheral nerves (yellow).

    © 2008 Nucleus Medical Art, Inc.

Individuals with somatization disorder may:

  • Complain about these symptoms in a very dramatic way, yet describe the symptoms in very vague or unclear terms
  • Visit more than one doctor for diagnosis and treatment for the same symptoms
  • Have test results that do not confirm any medical illness to explain their symptoms

It is important to understand that a person with somatization disorder is not intentionally producing or pretending to experience these physical complaints.

If you experience any of these symptoms do not assume it is due to somatization disorder. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician.

Diagnosis

There are no specific tests to determine whether or not a person has somatization disorder.

Your doctor will ask about your symptoms, medical history, and mental health history. Then your doctor will perform a physical exam. It is important for your doctor to rule out other diagnoses that are sometimes misdiagnosed as somatization disorder, including multiple sclerosis , lupus , and other endocrine (hormonal) conditions.

If your doctor does not find anything serious in these tests, your doctor may refer you to a psychologist or psychiatrist.

Treatment

The goal of treatment is to make you feel like you can control the symptoms and help you begin to function properly in work and social situations. Talk with your doctor about the best treatment plan for you. It is important to have a long-term relationship with your doctor, who should be empathetic and caring about your issues.

Other treatment options your doctor may suggest include the following:

  • Psychotherapy—You talk and work with a psychiatrist, psychologist, social worker, or licensed counselor to figure out ways to deals with stressful or painful issues.
  • Cognitive behavioral therapy—A mental health professional will work with you to focus on practical ways to cope with the symptoms.
  • Medications—Sometimes, an antidepressant (a medication that relieves depression) is recommended. If anxiety is present, a medication that relieves anxiety may be prescribed.

Prevention

There are no known ways to prevent somatization disorder. To help reduce your chances of developing somatization disorder, take the following steps:

  • Reduce the amount of stress in your life.
  • Continue to be aware of your psychological or emotional health.
  • Maintain an open and good relationship with your primary care doctor or healthcare provider.

RESOURCES:

American Psychiatric Association
http://www.psych.org

American Psychological Association
http://www.apa.org

National Institute of Mental Health
http://www.nimh.nih.gov

National Mental Health Association
http://www.nmha.org

CANADIAN RESOURCES:

Canadian Psychiatric Association
http://www.cpa-apc.org

Mental Health Canada
http://www.mentalhealthcanada.com/

References:

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy . Merck website. Available at: http://www.merck.com/mrkshared/mmanual/section15/chapter186/186b.jsp . Accessed July 11, 2005.

Eisendrath SJ. “Somatization disorder” in Ferri’s Clinical Advisor: Instant Diagnosis and Treatment . 8th ed. Philadelphia, PA: Mosby; 2006.

Francois M. Somatization disorder: a practical review. The Canadian Journal of Psychiatry. October 2004. Canadian Psychiatric Association website. Available at: http://www.cpa-apc.org/Publications/Archives/CJP/2004/october/mai.asp . Accessed July 11, 2005.

Servan-Schreiber D, Kolb NR, Tabas G. Somatizing patients: part I. Practical diagnosis. AM Fam Physician . February 15, 2000. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20000215/1073.html . Accessed July 11, 2005.

Somatization disorder. Medical Encyclopedia, US National Library of Medicine and the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000955.htm .



Last reviewed January 2008 by Theodor B. Rais, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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