Somatization Disorder
Pathophysiology
- Increased Bodily sensitivity
- symptoms of somatization disorder represent the body’s own defense against psychological stress.
- caused by one’s own negative thoughts and overemphasized fears.
Somatization Disorder
is a somatoform disorder characterized by recurring, multiple, clinically significant complaints about pain, gastrointestinal, sexual and pseudoneurological symptoms.Individuals with somatization disorder typically visit many doctors in pursuit of effective treatment. Somatization disorder also causes challenge and burden on the life of the caregivers or significant others of the patient.
A somatoform disorder involving the expression of psychological issues through bodily problems that have no basis in physiological function.
Management
Neuroimaging evidence
A recent review of the cognitive– affective neuroscience of somatization disorder suggested that catastrophization in patients with somatization disorders tend to present a greater vulnerability to pain. The relevant brain regions include the dorsolateral prefrontal, insular, rostral anterior cingulate, premotor, and parietal cortices
Diagnosis
The DSM-IV-TR diagnostic criteria are:
- A history of somatic complaints over several years, starting prior to the age of 30.
- At least four different sites of pain on the body, and at least two gastrointestinal problems, and one sexual dysfunction, and one pseudoneurological symptom.
Discuss the diagnosis
Regular Visits
Psychotherapy
Life style changes
Problems
- There is usually co-morbidity with other psychological disorders, particularly mood disorders or anxiety disorders.
- About 10-20 percent of female first degree relatives also have somatization disorder, and male relatives are have increased rates of alcoholism and sociopathy.
- More common among less educated and less income
Case Study
- Complaints are not feigned as in malingering or factitious disorder.
Treatment
Ms. B, a middle- aged woman, presented with a complaint of back
pain and headaches. the headaches had occured only during the back pain episodes, which had been present on and off for two weeks. in the course of obtaining Ms. B's history, many items stood out. she had been taking alprazolam for anxiety, and ranitidine for for gastroesophageal reflux, with a history of peptic ulcer disease (diagnosed by history). she stated that she could not take ibuprofen. a record review revealed mixed headache disorder; tension headaches, possibly migraine type, treated with citaloprom; myoclonus muscle muscle jerks of legs arms and torso that were worked up by neurology and for which she declined medications; sinusitis; and generalized anxiety disorder. ruled out were attention deficit hyperactivity disorder, post traumatic stress disorder, obsessive compulsive disorder, irritable bowel syndrome and carpal tunnel syndrome. she had smoke for more than two decades. she later was seen by several providers before coming. In for irreproducible posterior chest wall pain, described as a dull ache between the lower left shoulder blade and ribs.
EPIDEMIOLOGY
- Somatization disorder is uncommon in the general population. It is thought to occur in 0.2% to 2% of females,and 0.2% of males. Research showed cultural differences in prevalence of somatization disorder. For example, somatization disorder and symptoms were found to be significantly more common in Puerto Rico.
cognitive behavioral therapy (CBT) is the best established treatment for a variety of somatoform disorders including somatization disorder.
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.