Understanding Somatization Disorder

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Somatization disorder is a psychiatric condition in which the sufferer experiences multiple physical symptoms that are not explained by disease. It is classified as a "somatoform disorder." While at first, the disorder can seem similar to hypochondriasis and nosophobia, the difference is that those who suffer from either hypochondriasis or nosophobia are afraid of being sick.

The physical symptoms that people with somatization disorder may experience include pain, weakness, fatigue and shortness of breath.

They may describe the symptoms as mild or severe, and the symptoms may come and go.

The symptoms of somatization disorder may be caused by a medical problem, but often, no physical cause can be found. However, it isn't the symptoms that are the feature of somatization disorder, but rather the extreme reaction to the symptoms and related behaviors. These reactions and behaviors include:

  • Experiencing extreme anxiety about symptoms
  • Experiencing concern that mild symptoms are a sign of serious disease
  • Visiting the doctor and not believing the results of multiple tests and procedures
  • Believing physicians aren't taking symptoms seriously enough
  • Spending a disproportionate amount of time and energy thinking about health concerns
  • Experiencing difficulty functioning because of thoughts, feelings, and behaviors about symptoms

Who Is at Risk for Somatization Disorder?

While somatization disorder can affect anybody, it usually begins before age 30 and is more likely to affect those who:

  • Are female
  • Have a history of physical or sexual abuse
  • Have a negative outlook on life
  • Are more physically and emotionally sensitive to pain and other sensations
  • Have a genetic predisposition to worrying

Criteria for Diagnosing Somatization Disorder

According to the Diagnostic and Statistical Manual, 4th Ed., (DSM-IV) diagnosis of somatization disorder has several criteria.

These include:

  • A history of somatic symptoms before age 30
  • Four or more separate physical symptoms in different parts of the body
  • One sexual symptom
  • Two gastrointestinal symptoms beyond pain
  • At least one neurological complaint, such as fainting

The remaining DSM-IV criterion is that the symptoms must not be "intentionally produced or feigned." This is important to note -- by making a diagnosis of somatization disorder, a physician must believe that the patient is not faking the symptoms in any way.

Distinguishing Somatization Disorder from Other Mental Health Conditions

These complaints may be dramatic, but may also come and go. These symptoms often go hand in hand with symptoms of anxiety or a mood disorder. Furthermore, as patients with these problems often go to multiple doctors trying to find a diagnosis other than somatization disorder, they may also be suffering from side effects of many different medications.

If the main symptoms cannot be attributed to a known general medical condition or the direct effects of some substance, or if the physical complaints and resulting impairment are greater than what would be expected based on the physical exam, history and lab studies, the patient meets most criteria for a diagnosis of somatization disorder.

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