Definition

Individuals with somatization disorder report suffering constantly and often for many years from many physical illnesses. However, they do not have any specific, diagnosed medical illnesses that can explain the presence or severity of their symptoms. Still, these symptoms cause distress and negatively impact their ability to function day to day.

Causes

The cause of somatization disorder is not known.

There is no medical illness to explain the symptoms, so the disorder is believed to be due to mental and emotional causes. Somatization disorder may also be due to brain processing.

Risk Factors

Somatization disorder is more common in American women, but incidence varies among different cultures. Other factors that may increase your chance of developing somatization disorder include:

• Family history of somatization disorder
• History of psychological trauma or early experiences with physical illness, hospitalization and medical treatment
• Lower social class with little education
• Individuals who may be extremely emotional (also known histrionic)
• Individuals with antisocial personality disorder, substance abuse disorders, anxiety, depression, or panic disorder
• Individuals who are unable to express their emotional distress through language (due to neurological disorders or intellectual disability), or in cultures that discourage the communication of emotional distress

Symptoms

The physical suffering that people with somatization disorder experience usually begin in the early adult years. It can also begin during the teenage years. Individuals suffer for years, often leading to many unnecessary medical tests and treatments.

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 that occur over several years.

Somatization disorder may cause:

• Pain symptoms in any part of the body, such as back, joints chest, or head
• Gastrointestinal symptoms other than pain, such as nausea, vomiting, bloating, or diarrhea
• Sexual symptoms other than pain, such as erectile difficulty, irregular menstrual periods, or excessive menstrual bleeding
• Neurological symptoms, such as:
  • 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
  • Temporary blindness or deafness
  • Seizures

  Nervous System An emotional event may trigger physical symptoms, sometimes through peripheral nerves (yellow). Copyright © Nucleus Medical Media, 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.

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. A physical exam will be done. It is important for your doctor to rule out other diagnoses that are sometimes misdiagnosed as somatization disorder.

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:

• Psychotherapy—Talking 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 symptoms.
• Medications—If you have another disorder, such as depression or anxiety, it may be treated with medications.

Prevention

There are no current guidelines to prevent somatization disorder. To help reduce your chances of developing somatization disorder:

• Seek treatment for any related emotional disorders
• Find healthy ways to reduce the amount of stress in your life, such as exercise.

American Psychological Association http://www.apa.org/helpcenter/index.aspx

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

Servan-Schreiber D, Kolb NR, et al. Somatizing patients: Part I. Practical diagnosis. Am Fam Physician. 2000;61(4):1073-1078.

Somatic symptom disorder. Merck Manual Professional Version website. Available at:
http://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/somatic-symptom-disorder
Updated February 2012. Accessed July 22, 2013.