Somatization is the generation of somatic symptoms due to

psychological distress Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, ...

, often coinciding with a tendency to seek medical help for them. The term ''somatization'' was introduced by Wilhelm Stekel in 1924. Somatization is a worldwide phenomenon, with chronic cases being classified as

somatic symptom disorder Somatic symptom disorder, also known as somatoform disorder or somatization disorder, is chronic somatization. One or more chronic physical symptoms coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symp ...

Associated conditions

Somatization can be, but is not always, related to certain psychiatric conditions such as: *

Mood disorders A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where the main underlying characteristic is a disturbance in the person's mood. The classification is in the ''Diagnostic ...

(e.g.,

major depressive disorder Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive depression (mood), low mood, low self-esteem, and anhedonia, loss of interest or pleasure in normally ...

) *

Anxiety disorders Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause phys ...

Somatic symptom disorder Somatic symptom disorder, also known as somatoform disorder or somatization disorder, is chronic somatization. One or more chronic physical symptoms coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symp ...

The

American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 39,200 members who are in ...

(APA) has classified somatoform disorders in the

DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...

and the

World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...

(WHO) have classified these in the

ICD-10 ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social cir ...

. Both classification systems use similar criteria. Most current practitioners will use one over the other, though in cases of borderline diagnoses, both systems may be referred to.

Theory

Ego defense

In psychodynamic theory, somatization is conceptualized as an ego defense, the unconscious rechannelling of repressed emotions into somatic symptoms as a form of symbolic communication ( organ language).

Sigmund Freud Sigmund Freud ( ; ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies seen as originating fro ...

's case study of

Anna O. Bertha Pappenheim (27 February 1859 – 28 May 1936) was an Austrian-Jewish feminist, a social pioneer, and the founder of the Jewish Women's Association (). Under the pseudonym Anna O., she was also one of Josef Breuer's best-documented pat ...

featured a woman who suffered from numerous physical symptoms, which Freud believed were the result of repressed grief over her father's illness, although his assessment has been questioned by later research as treatment did not resolve her symptoms.

Treatment

Treatment for somatic symptom disorder typically combines different strategies for managing the patient's symptoms including regularly scheduled outpatient visits, psychosocial interventions (e.g., joint meetings with family members), psychoeducation, and treatment of prominent

comorbid In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sicknes ...

symptoms of

anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...

or depression. Based on multiple systematic reviews, the initial suggested treatment for somatic symptom disorder is regular, scheduled outpatient visits every 4–8 weeks that are not based on active symptoms. These visits often focus on establishing a therapeutic alliance, legitimizing the somatic symptoms, and limiting diagnostic tests and referral to specialists.

References

External links