Somatization Disorder: When The Body Speaks

People with somatization disorder often have multiple somatic (body) symptoms that cause discomfort or can cause significant problems in daily life. However, sometimes they can have only one serious symptom and not several of them. In these cases, the most characteristic symptom is pain.

Symptoms can be specific (eg, localized pain) or relatively nonspecific (eg, fatigue). Symptoms sometimes denote normal body sensations or discomfort that usually does not signify a serious illness. Be that as it may, we are facing a more common type of condition than we may think.

Likewise, it should be noted that in the new version of the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) psychosomatic disorder receives special attention. Experts on the subject such as Dr. Teah Rosic, from the University of Ontario, Canada, point out that we are facing a psychological reality that requires more research and attention.

The suffering of the person with somatization disorder is real

The person with somatization disorder really suffers. Your discomfort is genuine, whether it is medically explained or not. Thus, the symptoms may or may not be associated with another medical condition. In fact, these people often have medical conditions along with somatization disorder.

• For example, a person could be severely disabled by symptoms of a somatization disorder after an uncomplicated myocardial infarction. This is so even if the myocardial infarction itself has not produced any disability.

• If there were another medical disease or a high risk of suffering from it, the thoughts, feelings and behaviors associated with this disease would be excessive in these people.
• On the other hand, people with somatization disorder tend to have very high levels of concern about the disease.
• In this way, they improperly evaluate your bodily symptoms and consider them threatening, harmful or annoying. They often think the worst about their health.

Health problems assume a central role in the life of the individual

In somatization disorder, health problems can take a central role in a person’s life. These problems can end up becoming a trait of your identity and finally end up dominating interpersonal relationships.

People with somatization disorder often experience discomfort that focuses primarily on the somatic symptoms and their meaning. 

When asked directly about their distress, some people describe it in relation to other aspects of their lives as well. Other people deny any source of distress other than somatic symptoms.

Thus, studies like the one carried out by the doctor 

The quality of life is reduced in these people

Health-related quality of life is often affected both physically and mentally. In somatization disorder, impairment is characteristic and, when persistent,  disability can result. In these cases, the patient often goes to consultation and even consult different specialists. However, this rarely eases your worries.

• These people often seem unresponsive to medical interventions, and new interventions can aggravate the presentation of symptoms, entering a vicious cycle.
• Some of these individuals appear unusually sensitive to the side effects of medications. Also, some feel that their medical evaluation and treatment have not been sufficient.

What characteristics do people with somatization disorder possess?

The traits that characterize people with somatization disorder are the following:

Cognitive or thinking characteristics

Cognitive features include focused attention to somatic symptoms and the attribution of normal bodily sensations to physical illness (possibly with catastrophic interpretations).

In addition, they also include concerns about illness and the fear that any physical activity could harm the body.

Behavioral characteristics

Associated relevant behavioral characteristics may be repeated body checking for abnormalities, repetitive seeking medical care and safety, and avoidance of physical activity. These behavioral characteristics are more pronounced in severe and persistent somatization disorders, as might be expected.

These characteristics are generally associated with frequent medical advice consultations for different bodily or somatic symptoms. This can lead to medical consultations in which individuals are so focused on their concerns about somatic symptoms that the conversation cannot be redirected to other matters.

Frequent doctor visits

Any attempt to reassure the doctor and to explain that the symptoms are not indicative of a serious physical illness is usually short-lived. Individuals experience it as if the doctor does not take their symptoms seriously.

Since focusing on bodily symptoms is a major feature of the disease, people with somatization disorder often turn to general medical health services rather than mental health services.

Individuals with somatization disorder may experience the suggestion of a referral to a mental health specialist with surprise or even outright rejection.

Since somatization disorder is associated with depressive disorders, there is an increased risk of suicide. It is not known whether somatization disorder is associated with suicide risk regardless of its association with depressive disorders.

What is the prevalence of somatization disorder?

The prevalence of somatization disorder is unknown, although it is estimated that in the general adult population it may be between 5 and 7%. On the other hand, it is believed to be less than that of undifferentiated somatoform disorder.

Furthermore, women tend to report more somatic symptoms than men. Thus, the prevalence of somatization disorder is probably, as a consequence, higher in women than in men.

Criteria that must be present to make the diagnosis of somatization disorder

The criteria that mental health specialists must take into account to make the diagnosis of somatization disorder are the following:

A. One or more somatic symptoms that cause discomfort or lead to significant problems in daily life.

B. Excessive thoughts, feelings, or behaviors related to somatic symptoms or associated with health concern, as evidenced by one or more of the following:

• Persistent and disproportionate thoughts about the severity of the symptoms themselves.
• Persistently high degree of anxiety about health or symptoms.
• Excessive time and energy devoted to these symptoms or concern for health.

C. Although some somatic symptom may not be continuously present, the symptomatic state is persistent (usually more than six months).

How does somatization disorder develop and what is its course?

Somatic symptoms and concurrent medical illnesses are common in older people . Thus, a focus on criterion B is crucial to making the diagnosis.

• Somatization disorder may be underdiagnosed in older adults. This is because certain somatic symptoms (eg pain, fatigue) are considered part of normal aging.
• Also because concern about illness is considered “understandable” in older people, who generally have more medical illnesses and need more medications than younger ones.
• Depression is also common in older people with numerous somatic symptoms.

Somatization disorder in children

In children, the most common symptoms are recurrent abdominal pain, headache, fatigue, and nausea. It is more common for a single symptom to predominate in children than in adults. Although young children may have somatic complaints, it is rare for them to become preoccupied with the “illness” per se before adolescence.

Parents’ response to symptoms is important, as this can determine the level of associated distress. Parents can be decisive in interpreting symptoms, missing school, and seeking medical help.

As we have seen, somatization disorder is associated with a significant deterioration in health status and with other disorders such as depression or anxiety. In this sense, seeking psychological help is essential to improve the quality of life of these patients.