Medical examination would provide object evidence of subjective complaints of the individual.Diagnosis of somatization disorder is difficult because it is hard to determine to what degree psychological factors are exacerbating subjective feelings of pain. For instance, chronic pain is common in 30% of the U.S. population, making it difficult to determine whether or not the pain is due to predominantly psychological factors. ICD-10
In ICD-10, the latest version of the International Statistical Classification of Diseases and Related Health Problems, somatization syndrome is described as:
"The main features are multiple, recurrent and frequently changing physical symptoms of at least two years duration. Most patients have a long and complicated history of contact with both primary and specialist medical care services, during which many negative investigations or fruitless exploratory operations may have been carried out. Symptoms may be referred to any part or system of the body. The course of the disorder is chronic and fluctuating, and is often associated with disruption of social, interpersonal, and family behaviour." ICD-10 also includes the following subgroups of somatization syndrome:
Undifferentiated somatoform disorder. Hypochondriasis. Somatoform autonomic dysfunction. Persistent somatoform pain disorder. Other somatoform disorders, such ones predominated by dysmenorrhoea, dysphagia, pruritus and torticollis. Somatoform disorder, unspecified. Cause
Although somatization disorder has been studied and diagnosed for more than a century, there is debate and uncertainty regarding its pathophysiology. Most current explanations focus on the concept of a misconnection between the mind and the body.
Electroconvulsive shock therapy (ECT) has been used in treating somatization disorder among the elderly; however, the results were still debatable with some concerns around the side effects of using ECT. Overall, psychologists recommend addressing a common difficulty in patients with somatization disorder in the reading of their own emotions. This may be a central feature of treatment; as well as developing a close collaboration between the GP, the patient and the mental health practitioner. Epidemiology
Somatization disorder is estimated to occur in 0.2% to 2% of females, and 0.2% of males. There are cultural differences in the prevalence of somatization disorder. For example, somatization disorder and symptoms were found to be significantly more common in Puerto Rico. In addition the diagnosis is also more prevalent among African Americans and those with less than a high school education or lower socioeconomic status.There is usually co-morbidity with other psychological disorders, particularly mood disorders or anxiety disorders. Research also showed comorbidity between somatization disorder and personality disorders, especially antisocial, borderline, narcissistic, histrionic, avoidant, and dependent personality disorder.About 10-20 percent of female first degree relatives also have somatization disorder and male relatives have increased rates of alcoholism and sociopathy. See also
Body-centred countertransference
Culture-bound syndrome
Hypochondriasis
Medically unexplained symptoms
Psychosomatic illness
Munchausen syndrome

References


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