Somatization
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Somatization is the generation of somatic symptoms due to psychological distress, often coinciding with a tendency to seek medical help for them.[1][2] The term somatization was introduced by Wilhelm Stekel in 1924.[3]
Somatization is a worldwide phenomenon,[4] with chronic cases being classified as somatic symptom disorder.[5]
Associated conditions
[edit]Somatization can be, but is not always, related to certain psychiatric conditions such as:[6]
The American Psychiatric Association (APA) has classified somatoform disorders in the DSM-IV and the World Health Organization (WHO) have classified these in the ICD-10. 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
[edit]Ego defense
[edit]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).[7]
Sigmund Freud's case study of Anna O. 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.[8]
Treatment
[edit]Treatment for somatic symptom disorder typically combine different strategies for managing the patient's symptoms including regularly scheduled outpatient visits, psychosocial interventions (e.g., joint meetings with family members),[9][medical citation needed] psychoeducation, and treatment of prominent comorbid symptoms of anxiety or depression.[citation needed]
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.[10][11]
See also
[edit]- Psychosomatic medicine
- Identified patient
- Amplification (psychology)
- Hypochondriasis
- Medically unexplained physical symptoms
- Nocebo
- Somatic marker hypothesis
References
[edit]- ^ Lipowski ZJ (1988). "Somatization: the concept and its clinical application". Am J Psychiatry. 145 (11): 1358–68. doi:10.1176/ajp.145.11.1358. PMID 3056044.
- ^ Adriana Feder, M.D. Somatization
- ^ R. L. Woolfolk/L. A. Allen, Treating Somatization (2006) p. 5
- ^ P. S. Sutker/H. E. Adams, Comprehensive Handbook of Psychopathology (2001) p. 217
- ^ Woolfolk/Allen, pp. 14–5
- ^ Smith RC, Gardiner JC, Lyles JS, et al. (2005). "Exploration of DSM-IV criteria in primary care patients with medically unexplained symptoms". Psychosomatic Medicine. 67 (1): 123–9. doi:10.1097/01.psy.0000149279.10978.3e. PMC 1894627. PMID 15673634.
- ^ P. S. Sutker/H. E. Adams, Comprehensive Handbook of Psychopathology (2001) p. 216
- ^ Gupta, Deepti; Perez Edgar (Jan 2012). "The role of temperament in somatic complaints among young female adults". Journal of Health Psychology. 17 (1): 26–35. doi:10.1177/1359105311405351. PMID 21562070. S2CID 20095444.
- ^ Woolfolk, pp. 41–3
- ^ Gordon-Elliott, Janna S.; Muskin, Philip R. (November 2010). "An approach to the patient with multiple physical symptoms or chronic disease". The Medical Clinics of North America. 94 (6): 1207–1216, xi. doi:10.1016/j.mcna.2010.08.007. ISSN 1557-9859. PMID 20951278.
- ^ Croicu, Carmen; Chwastiak, Lydia; Katon, Wayne (September 2014). "Approach to the patient with multiple somatic symptoms". The Medical Clinics of North America. 98 (5): 1079–1095. doi:10.1016/j.mcna.2014.06.007. ISSN 1557-9859. PMID 25134874.