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Updated 19 February 2016

Somatisation

Somatisation occurs when a person develops physical symptoms caused by stress.

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Summary

  • Somatisation disorder occurs when a person develops physical symptoms caused by stress or emotional problems.
  • Because the physical symptoms are caused by psychological problems, no underlying physical problem can be identified.
  • Although it can't be explained medically, the physical symptoms actually exist and are not just imagined by the patient.
  • Counselling or other psychological interventions may help people who are prone to somatisation learn other ways of dealing with stresses.

Alternative names

Briquet's syndrome; hysteria

What is somatisation disorder?

Somatisation disorder occurs when a person develops physical symptoms caused by stress or emotional problems. It is a chronic condition in which there are numerous physical complaints throughout the body that can't be explained by means of medical testing. Symptoms caused by the disease actually exist and are by no means just in the patient's imagination.

Usually patients suffering from somatisation disorder regularly visit doctors and in some cases may even have undergone unnecessary treatment and/or medical procedures to no avail.

Somatisation disorder is not the same as factitious disorder or Munchausen's syndrome where the symptoms are faked to get attention or receive care.

What causes somatisation disorder?

Environmental as well as genetic factors may contribute to the risk of developing this disorder. It usually begins between the ages of 18 and 30 and occurs more often in women than in men.

It may originate as a reaction to depression or anxiety or as a response to several psycho-social stresses. And it persists long after the problem has been resolved.

The symptoms are generally severe enough to interfere with work and relationships and often the patient regularly visit the doctor and even undergo unnecessary procedures and take medication. A lifelong history of "sickliness" is often present.

Stress often worsens the symptoms.

What are the symptoms of somatisation disorder?

Some of the numerous symptoms that can occur with somatisation disorder include:

  • Vomiting
  • Abdominal pain
  • Nausea
  • Bloating
  • Diarrhoea
  • Pain in the legs or arms
  • Back pain
  • Joint pain
  • Pain during urination
  • Headaches
  • Shortness of breath
  • Palpitations
  • Chest pain
  • Dizziness
  • Amnesia
  • Difficulty swallowing
  • Vision changes
  • Paralysis or muscle weakness
  • Sexual apathy
  • Pain during intercourse
  • Impotence
  • Painful menstruation
  • Irregular menstruation
  • Excessive menstrual bleeding

It is important to note that many of these symptoms also occur in other medical and psychiatric disorders. When a person experiences any of these symptoms, they should work with a doctor to rule out possible causes before a diagnosis of somatisation disorder is made.

How is somatisation disorder diagnosed?

A thorough physical examination and diagnostic tests are performed to rule out physical causes. Which tests are done depends on the symptoms the patient experiences.

Then a psychological evaluation is performed to rule out related disorders.

How is somatisation disorder treated?

Once other causes have been ruled out and a diagnosis of somatisation disorder has been made, the goal of treatment is to help the person learn to control the symptoms.

There is often an underlying mood disorder which can respond to antidepressant medications.

Counselling may help identify and face emotional issues and psychological treatment can be used to change long-standing patterns of behaviour.

A supportive relationship with a sympathetic doctor is the most important aspect of treatment. Regularly scheduled appointments should be maintained to review symptoms and the person's coping mechanisms.

What is the prognosis?

Medications may provide some relief. Psychotherapy tends to proceed slowly, because the person probably has been living with the disorder for many years before starting treatment. It is difficult to give up long-standing patterns of behaviour, but with persistence and support, progress is possible.

When to call your doctor?

A good relationship with a consistent and sympathetic doctor is helpful. A healthcare provider should be contacted when there is a significant change in symptoms.

How can somatisation disorder be prevented?

Counselling or other psychological interventions may help people who are prone to somatisation learn other ways of dealing with stresses. This may help reduce the intensity of the symptoms.

 
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