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{{DiseaseDisorder infobox |
__NOTOC__
  Name        = Somatization disorder |
  ICD10      = {{ICD10|F|45|0|f|40}} |
  ICD9        = {{ICD9|300.81}} |
}}
{{SI}}
{{SI}}
{{CMG}}
{{CMG}}
{{SK}} Briquet's disorder


==Overview==
==Overview==
'''Somatization disorder''' (also '''Briquet's disorder''' or, in antiquity, '''hysteria''') is a psychiatric diagnosis applied to patients who chronically and persistently complain of varied physical symptoms that have no identifiable physical origin. One common general [[etiology|etiological]] explanation is that internal [[psychological]] conflicts are [[Unconscious mind|unconscious]]ly expressed as physical signs.
Somatization disorder is a psychiatric diagnosis applied to patients who chronically and persistently complain of varied physical symptoms that have no identifiable physical origin. One common general [[etiology|etiological]] explanation is that internal [[psychological]] conflicts are [[Unconscious mind|unconscious]]ly expressed as physical signs.


==Criteria==
==Pathophysiology==
There is usually co-morbidity with other psychological disorders, particularly mood or anxiety disorders.
 
==Epidemiology and Demographics==
===Prevalence===
Somatization disorder is not common in the general population.
===Gender===
It is thought to occur in 0.2% to 2% of females,<ref>deGruy F, Columbia L, Dickinson P. (1987) "Somatization disorder in a family practice," ''J Fam Pract.'', 25(1):45–51.</ref><ref>Lichstein, P. R. (1986). "Caring for the patient with multiple somatic complaints," ''Southern Medical Journal'', 79(3), 310-314</ref><ref>Gordon, G.H. (1987). "Treating somatizing patients," ''Western Journal of Medicine'', 147, 88-91.</ref><ref>Farley J, Woodruff RA, Guze SB (1968). "The prevalence of hysteria
and conversion symptoms," ''The British Journal of Psychiatry'', 114:1121–1125 (1968).</ref> and, according to the DSM-IV, 0.2% of males.<ref>American Psychiatric Association. (1994). ''Diagnostic and statistical manual of mental disorders'' (4th ed.). Washington, DC.</ref>
 
==Natural History, Complications and Prognosis==
This condition is chronic and has a poor prognosis.
 
==Diagnosis==
===History and Symptoms===
====Criteria====
Somatization disorder is  a [[somatoform disorder]]. The [[Diagnostic and Statistical Manual of Mental Disorders|''DSM-IV'']] establishes the following five criteria for the diagnosis of this disorder:  
Somatization disorder is  a [[somatoform disorder]]. The [[Diagnostic and Statistical Manual of Mental Disorders|''DSM-IV'']] establishes the following five criteria for the diagnosis of this disorder:  
*a history of somatic symptoms prior to the age of 30
*A history of somatic symptoms prior to the age of 30
*pain in at least four different sites on the body
*Pain in at least four different sites on the body
*two gastrointestinal problems other than pain such as vomiting or diarrhea
*Two gastrointestinal problems other than pain such as vomiting or diarrhea
*one sexual symptom such as lack of interest or erectile dysfunction
*One sexual symptom such as lack of interest or erectile dysfunction
*one pseudoneurological symptom similar to those seen in [[Conversion disorder]] such as fainting or    blindness.
*One pseudoneurological symptom similar to those seen in [[Conversion disorder]] such as fainting or    blindness.


Such symptoms cannot be related to any medical condition. The symptoms do not all have to be occurring at the same time, but may occur over the course of the disorder. If a medical condition is present, then the symptoms must be excessive enough to warrant a separate diagnosis. Two symptoms can not be counted for the same thing e.g.if pain during intercourse is counted as a sexual symptom it can not be counted as a pain symptom. Finally, the symptoms cannot be being feigned out of an effort to gain attention or anything else by being sick, and they can not be deliberately induced symptoms.
Such symptoms cannot be related to any medical condition. The symptoms do not all have to be occurring at the same time, but may occur over the course of the disorder. If a medical condition is present, then the symptoms must be excessive enough to warrant a separate diagnosis. Two symptoms can not be counted for the same thing e.g.if pain during intercourse is counted as a sexual symptom it can not be counted as a pain symptom. Finally, the symptoms cannot be being feigned out of an effort to gain attention or anything else by being sick, and they can not be deliberately induced symptoms.
==Prevalence==
Somatization disorder is not common in the general population. It is thought to occur in 0.2% to 2% of females,<ref>deGruy F, Columbia L, Dickinson P. (1987) "Somatization disorder in a family practice," ''J Fam Pract.'', 25(1):45–51.</ref><ref>Lichstein, P. R. (1986). "Caring for the patient with multiple somatic complaints," ''Southern Medical Journal'', 79(3), 310-314</ref><ref>Gordon, G.H. (1987). "Treating somatizing patients," ''Western Journal of Medicine'', 147, 88-91.</ref><ref>Farley J, Woodruff RA, Guze SB (1968). "The prevalence of hysteria
and conversion symptoms," ''The British Journal of Psychiatry'', 114:1121–1125 (1968).</ref> and, according to the DSM-IV, 0.2% of males.<ref>American Psychiatric Association. (1994). ''Diagnostic and statistical manual of mental disorders'' (4th ed.). Washington, DC.</ref> There is usually co-morbidity with other psychological disorders, particularly mood or anxiety disorders. This condition is chronic and has a poor prognosis.


==Treatment==
==Treatment==
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Collaboration between a psychiatrist and primary care physician may help.<ref name="pmid3084975">{{cite journal |author=Smith GR, Monson RA, Ray DC |title=Psychiatric consultation in somatization disorder. A randomized controlled study |journal=N. Engl. J. Med. |volume=314 |issue=22 |pages=1407-13 |year=1986 |pmid=3084975 |doi=}}</ref>
Collaboration between a psychiatrist and primary care physician may help.<ref name="pmid3084975">{{cite journal |author=Smith GR, Monson RA, Ray DC |title=Psychiatric consultation in somatization disorder. A randomized controlled study |journal=N. Engl. J. Med. |volume=314 |issue=22 |pages=1407-13 |year=1986 |pmid=3084975 |doi=}}</ref>


==References==
==Related Chapters==
{{reflist}}
----
*American Psychiatric Association. (1994). ''Diagnostic and statistical manual of mental disorders'' (4th ed.). Washington, DC.
*Barlow, David H. and V. Mark Durand (2006). ''Essentials of Abnormal Psychology'' (4th ed.) Belmont, CA.
*Bizer, J. (2003). "Somatization disorders in obstetrics and gynecology."  ''Achieves of Women’s Mental Health,'' 6, 99-107.
*Hakala, M. (2004). "Volumes of the caudate nuclei in women with somatization disorder and healthy women." ''Psychiatry Research'', 131(1), 71-78.
*Hakala, M., Karlsson, H., Ruotsalainen, U., Koponen, S., Bergman, J., Stenman, H., et al. (2002). "Severe somatization in women is associated with altered cerebral glucose metabolism."  ''Psychological Medicine,'' 32(8), 1379-1385.
*Holder-Perkins, V., & Wise, T.N. (2001). "Somatization Disorder." In J.M. Oldham & M.B. Riba (Series Eds.) & K.A. Phillips (Vol. Ed.), ''Review of Psychiatry: Vol. 20. Somatization and Factitious Disorder (pp 1-26)''. Washington, DC: American Psychiatric Publishing.
*Looper, K.J., & Kirmayer, L.J. (2002). "Behavioral medicine approaches to somatoform disorders."  ''Journal of Consulting and Clinical Psychology,'' 70(3), 810-827.
*Martini, D.R. (Spring 1997). [http://www.childsdoc.org/spring97/martini/somatoformdis.asp Somatoform disorders in the pediatric population.] Journal of Children’s Memorial Hospital. Retrieved December 7, 2004.
*Niemi, P.M., Portin, R., Aalto, S., Hakala, M., & Karlsson, H. (2002). Cognitive functioning in severe somatization—a pilot study.  Acta Psychiatrica Scandinavica, 106, 461-463.
*Stahl, S.M. (2003). Antidepressants and somatic symptoms: Therapeutic actions are expanding beyond affective spectrum disorders to functional somatic syndromes. Journal of Clinical Psychiatry, 64(7), 745-746.
*Temple, S. (2003). A case of multiple chemical sensitivities: Cognitive therapy for somatization disorder and Metaworry.  Journal of Cognitive Psychotherapy, 17(3), 267-277.
 
==See also==
*[[Culture-bound syndrome]]
*[[Culture-bound syndrome]]
*[[Psychosomatic illness]]
*[[Psychosomatic illness]]
==References==
{{Reflist|2}}


{{Mental and behavioural disorders}}
{{Mental and behavioural disorders}}
{{SIB}}
 


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[[Category:Somatoform disorders]]
[[Category:Somatoform disorders]]
[[Category:Psychiatry]]
[[Category:Psychiatry]]
[[Category:Signs and symptoms]]
[[Category:Disease]]
[[Category:Primary care]]
[[Category:Emergency medicine]]
[[Category:Mature chapter]]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Briquet's disorder

Overview

Somatization disorder is a psychiatric diagnosis applied to patients who chronically and persistently complain of varied physical symptoms that have no identifiable physical origin. One common general etiological explanation is that internal psychological conflicts are unconsciously expressed as physical signs.

Pathophysiology

There is usually co-morbidity with other psychological disorders, particularly mood or anxiety disorders.

Epidemiology and Demographics

Prevalence

Somatization disorder is not common in the general population.

Gender

It is thought to occur in 0.2% to 2% of females,[1][2][3][4] and, according to the DSM-IV, 0.2% of males.[5]

Natural History, Complications and Prognosis

This condition is chronic and has a poor prognosis.

Diagnosis

History and Symptoms

Criteria

Somatization disorder is a somatoform disorder. The DSM-IV establishes the following five criteria for the diagnosis of this disorder:

  • A history of somatic symptoms prior to the age of 30
  • Pain in at least four different sites on the body
  • Two gastrointestinal problems other than pain such as vomiting or diarrhea
  • One sexual symptom such as lack of interest or erectile dysfunction
  • One pseudoneurological symptom similar to those seen in Conversion disorder such as fainting or blindness.

Such symptoms cannot be related to any medical condition. The symptoms do not all have to be occurring at the same time, but may occur over the course of the disorder. If a medical condition is present, then the symptoms must be excessive enough to warrant a separate diagnosis. Two symptoms can not be counted for the same thing e.g.if pain during intercourse is counted as a sexual symptom it can not be counted as a pain symptom. Finally, the symptoms cannot be being feigned out of an effort to gain attention or anything else by being sick, and they can not be deliberately induced symptoms.

Treatment

No one treatment has been found to cure somatization disorder. However, setting up a physician that screens complaints from patients before they are allowed to see a specialist significantly cuts down on cost of the disorder. Antidepressants and cognitive behavioral therapy have been shown to help treat the disorder.

Collaboration between a psychiatrist and primary care physician may help.[6]

Related Chapters

References

  1. deGruy F, Columbia L, Dickinson P. (1987) "Somatization disorder in a family practice," J Fam Pract., 25(1):45–51.
  2. Lichstein, P. R. (1986). "Caring for the patient with multiple somatic complaints," Southern Medical Journal, 79(3), 310-314
  3. Gordon, G.H. (1987). "Treating somatizing patients," Western Journal of Medicine, 147, 88-91.
  4. Farley J, Woodruff RA, Guze SB (1968). "The prevalence of hysteria and conversion symptoms," The British Journal of Psychiatry, 114:1121–1125 (1968).
  5. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC.
  6. Smith GR, Monson RA, Ray DC (1986). "Psychiatric consultation in somatization disorder. A randomized controlled study". N. Engl. J. Med. 314 (22): 1407–13. PMID 3084975.


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