• Somatization Disorder

    (SD; Briquet’s Syndrome)

    Definition

    Individuals with somatization disorder report suffering constantly and often for many years from many physical illnesses. However, they do not have any specific, diagnosed medical illnesses that can explain their symptoms. Still, these symptoms cause distress and negatively impact their ability to function day-to-day.
    If you suspect you have this condition, contact your doctor for further evaluation.

    Causes

    The cause of somatization disorder is not known.
    There is no medical illness to explain the symptoms, so the disorder is believed to be due to mental and emotional causes. Somatiform disorder may also be due to brain processing.
    Often, symptoms seem to begin or get worse during stressful circumstances or in relation to emotional suffering, such as the loss of a friend. It is as if these stressful life situations are experienced physically.
    Researchers believe these components also may play a role in the disorder:
    • Genetics—It may run in your family.
    • Psychosocial—It may be due to a combination of factors that include your mental and emotional well-being and your environment or situation.

    Risk Factors

    The physical suffering that people with somatization disorder experience usually begins in the late 20s. It can also begin during the teenage years. Individuals suffer for years, often leading to many unnecessary medical tests and treatments.
    A risk factor is something that increases your chance of getting a disease or condition.
    Factors that increase your chance of developing somatization disorder include:
    • Lower social class with little education
    • Sex—The disorder is more common in American women. Its incidence also varies within different cultures.
    • Personality factors—Individuals are more likely to develop this disorder if they tend to act in a way that is extremely emotional (also known histrionic)
    • Individuals with antisocial personality disorder , substance abuse disorders, anxiety , depression , or panic disorders
    • May occur more frequently in individuals who are unable to express their emotional distress through language (due to neurological disorders or intellectual disability ), or in cultures that discourage the communication of emotional distress

    Symptoms

    People with somatization disorder complain about many physical illnesses that involve many different parts of their body. A diagnosis of somatization disorder requires experiencing an assortment of symptoms (at least three) for a considerable amount of time (causing suffering for at least two years).
    The symptoms include:
      Pain symptoms—these include pain experienced in any part of the body including:
      • Headaches
      • Back pain
      • Joint pain
      • Chest pain
      • Irregular heartbeat
      • Pain in arms or legs
      • Pain in vagina or penis during sexual intercourse
      • Pain during urination
      Gastrointestinal symptoms—these include any problem, other than pain, in the stomach or intestines, including:
      • Nausea
      • Bloating
      • Vomiting
      • Diarrhea
      Sexual symptoms—these include any problem, other than pain, in the sexual or reproduction system, including:
      • Inability to sustain an erection (men)
      • Irregular periods (women)
      • Excessive menstrual bleeding (women)
      Neurological symptoms—these include:
      • Being off-balance
      • Paralysis
      • Weakness
      • Trouble swallowing
      • Loss of voice
      • Inability to control the need to urinate
      • Delusions or hallucinations
      • Loss of touch
      • Unable to feel pain
      • Amnesia (loss of memory)
      • Temporary blindness
      • Temporary deafness
      • Seizures
      Nervous System
      Nervous system posterior 3D
      An emotional event may trigger physical symptoms, sometimes through peripheral nerves (yellow).
      Copyright © Nucleus Medical Media, Inc.
    Individuals with somatization disorder may:
    • Complain about these symptoms in a very dramatic way, yet describe the symptoms in very vague or unclear terms
    • Visit more than one doctor for diagnosis and treatment for the same symptoms
    • Have test results that do not confirm any medical illness to explain their symptoms
    It is important to understand that a person with somatization disorder is not intentionally producing or pretending to experience these physical complaints.
    If you experience any of these symptoms, do not assume it is due to somatization disorder. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician.

    Diagnosis

    There are no specific tests to determine whether or not a person has somatization disorder.
    Your doctor will ask about your symptoms, medical history, and mental health history. A physical exam will be done. It is important for your doctor to rule out other diagnoses that are sometimes misdiagnosed as somatization disorder, including multiple sclerosis , lupus , and other endocrine (hormonal) conditions.
    If your doctor does not find anything serious in these tests, your doctor may refer you to a psychologist or psychiatrist.

    Treatment

    The goal of treatment is to make you feel like you can control the symptoms and help you begin to function properly in work and social situations. Talk with your doctor about the best treatment plan for you. It is important to have a long-term relationship with your doctor, who should be empathetic and caring about your issues.
    Other treatment options your doctor may suggest include:
    • Psychotherapy—Talking with a psychiatrist, psychologist, social worker, or licensed counselor to figure out ways to deals with stressful or painful issues.
    • Cognitive behavioral therapy —A mental health professional will work with you to focus on practical ways to cope with symptoms.
    • Medications—Sometimes, an antidepressant (a medication that relieves depression) is recommended. If anxiety is present, a medication that relieves anxiety may be prescribed.

    Prevention

    There are no known ways to prevent somatization disorder. To help reduce your chances of developing somatization disorder, take the following steps:
    • Reduce the amount of stress in your life.
    • Continue to be aware of your psychological or emotional health.
    • Maintain an open and good relationship with your primary care doctor or healthcare provider.

    RESOURCES

    American Psychiatric Association http://www.psych.org/

    American Psychological Association http://www.apa.org/

    CANADIAN RESOURCES

    Canadian Psychiatric Association http://www.cpa-apc.org/

    Mental Health Canada http://www.mentalhealthcanada.com/

    References

    Eisendrath SJ. Somatization disorder. In: Ferri F. Ferri’s Clinical Advisor: Instant Diagnosis and Treatment . 8th ed. Philadelphia, PA: Mosby; 2006.

    LaFrance WC, Jr. Somatoform disorders. Sem Neurol. 2009;29:234-46.

    Servan-Schreiber D, Kolb NR, Tabas G. Somatizing patients: part I. Practical diagnosis. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20000215/1073.html . Published February 15, 2000. Accessed October 12, 2012.

    Somatization disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 1, 2012. Accessed October 12, 2012.

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