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Somatization: Introduction

Somatization

Somatization has traditionally referred to bodily symptoms thought to result from unconscious neurotic conflict. It is now used to describe patients who have a tendency to experience and communicate psychological and interpersonal distress in the form of physical symptoms or suffering, and to seek help for these symptoms.

Medically unexplained symptoms

"Medically unexplained symptoms" is the most widely used term for symptoms that are the focus of clinical attention and that disrupt the patient's quality of life, but for which a biomedical explanation cannot be found. Functional somatic syndrome is another term used to refer to these symptoms.

Functional somatic syndromes

Functional somatic syndromes are syndromes for which a clear pathophysiology has not yet been described and that are characterized by the reporting of medically unexplained symptoms and disability rather than agreed upon evidence of an underlying disease process (e.g., irritable bowel syndrome, non-cardiac chest pain, chronic fatigue syndrome, multiple chemical sensitivity).

The value of making these diagnoses is the subject of debate. It may be helpful in "ending the search" for a diagnosis. Yet in providing a diagnosis, primary care providers should emphasize the possibility of active management that improves the patient's functioning and quality of life.

Somatic symptom and related disorder

Somatic symptom disorder is a DSM- 5 diagnostic category (American Psychiatric Association, 2013). The category includes seven disorders presenting with physical symptoms that cause significant distress or impairment in daily functioning that might otherwise suggest a medical condition yet are not fully explained by a general medical condition, substance use or another psychiatric disorder. The seven disorders are:

  • somatic symptom disorder
  • illness anxiety disorder
  • conversion disorder
  • psychological factor affecting other medical conditions
  • factitious disorder
  • other specified somatic symptoms and related disorder
  • unspecified somatic symptom-related disorder

See: Highlights of Changes from DSM-IV-TR to DSM-5.


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