Somatization disorder

It is characterised by various somatic symptoms which cannot be explained by physical examination or laboratory tests. It was previously called hysteria.

In the general population it is thought to occur at a rate of 0.1-0.2 %. It occurs 5-20 times more in women than in men. 5-10% of patients visiting the general practitioner are diagnosed with this condition. The occurrence rate is higher in patients from lower educational and economic background. The onset is before the age of 30.

Psychosocial factors play an important role. It is an expression of emotions in social communication. It is thought that suppressed impulses are replaced by symptoms. Somato-sensorial input is misinterpreted. There is distractibility, inability to get used to repeated stimuli, inadequate selectivity. These show that cognitive functions play a role. The likelihood of coming across the condition in first degree relatives is as high as 10-20%, which points at the involvement of genetic factors.

There have to be at least four different sites of pain in the body, at least two gastrointestinal problems, one sexual dysfunction, one pseudo-neurological symptom. The most common symptoms are nausea-vomiting, difficulty in swallowing, pain in arms and legs, shortness of breath, forgetfulness, in women pregnancy problems and menstrual complications.

It is harmful to change practitioners frequently, treatment should be given by a single practitioner. Drug therapy, individual therapy and group therapy are beneficial.