Somatization: symptoms and treatment

By Cristiano Antonino Last updated Apr 1, 2023

Underlying Somatization Disorder are recurrent and multiple physical complaints, lasting several months or years, which lead those affected to seek medical attention, but which apparently do not appear to have an organic cause

Somatization disorders, an overview

According to the Manual of Mental Disorders, a person has somatization disorder (or more simply tends to somatize) if he or she complains of painful symptoms (e.g., headache, back pain, aching joints), two gastrointestinal (e.g., colitis, diarrhea, nausea), a sexual symptom other than pain alone (e.g., period pain, sexual indifference, erectile dysfunction), and a pseudo-neurological symptom (e.g., symptoms of conversion, such as impaired coordination or balance, dizziness, localized paralysis or weakness, difficulty swallowing or a lump in the throat).

The physical complaints in somatization disorder must begin before the age of 30, be ongoing for at least a few years, and cannot be fully explained by any known general medical condition or the direct effects of a substance.

If they occur in the presence of a general medical condition, the physical complaints or resulting social or occupational impairment are in excess of what would be expected from the history, physical examination, and laboratory findings.

Somatization disorder has a chronic but fluctuating course, rarely with complete remissions

In somatizing individuals, the type and frequency of psychosomatic symptoms can differ from one culture to another.

For example, burning hands and feet, or the non-delusional experience of having worms in the head, or ants crawling under the skin are more common symptoms in Africa and South Asia than in North America.

Patients who tend to somatize also tend to present their problems dramatically, vaguely, or exaggeratedly, or as part of a long and complicated medical history.

Anxiety and depression are very common and may be the reason they come under psychiatric observation.

When symptoms of somatization are present, there may be a wide range of interpersonal and behavioral problems, such as absenteeism, poor job performance, marital difficulties, impulsive and antisocial behavior, and suicide threats and attempts.

On a psychosomatic basis, a long series of physical problems that tend to be chronic and do not respond to medical therapies can occur.