What is a Somatoform Disorder?

A somatoform disorder is a mental disorder that is characterized by physical symptoms of a physical illness or injury which cannot be explained by other medical conditions. The symptoms are also not the result of substance use, or attributed to another mental illness.

Somatoform disorders are not the result of someone faking or trying to get attention. Those who have somatoform disorders believe that they are actually sick.

Read more about somatoform disorders.

Read more about Munchausen's.

Read more about Munchausen-by-proxy.

Somatoform disorders include the following (click the links to learn more about each disorder):

Conversion Disorder

Body Dysmorphic Disorder

Hypochondriasis

Somatization Disorder (read more below)

What is Somatization Disorder?

Somatization Disorder (also known as hysteria or Briquet's Syndrome) is a somatoform disorder in which an individual under the age of thirty experiences a number of long-term, recurring physical symptoms that cannot be attributed to a specific medical condition or illness. These physical symptoms are often about the gastrointestinal system, pain, sexual, or pseudoneurological symptoms and may last for several years.

It is important to note that these physical symptoms are real and are not imagined. Often, individuals with this disorder are accused of faking symptoms that are, in fact, legitimate medical complaints. They may often visit many doctors before a proper diagnosis is made, which may lead those with somatization disorder to be labeled as "treatment seekers," or "doctor shopping." In reality, someone with somatization disorder has legitimate symptoms that may not be properly diagnosed.

What Are The Causes of Somatization Disorder?

The precise cause for somatization disorder is, as yet, unknown. Some researchers believe that, due to a strong connection between the brain and the body, people with somatization disorder experience pain differently than others.

For example, an affected individual's brain may interpret physical pain in different, more extreme ways that lead to increased experienced pain levels. There also appears to be a link between emotional pain and stress and exacerbation of physical symptoms, whether that is the onset of symptoms as a trigger, or the worsening of the symptoms once present.

Prevalence of Somatization Disorder:

Somatization disorder is a relatively uncommon mental illness. It's suspected to occur in up to 2% of women and 0.2% of males.

Somatization disorder often occurs with other mental illnesses, especially mood disorders or anxiety disorders.

Read more about mood disorders.

Read more about anxiety disorders.

Risks for Developing Somatization Disorder:

While there are no specific indicators of who may or may not develop somatization disorder, it tends to occur more commonly in people who already suffer from irritable bowel syndrome or who have chronic pain issues. The onset of somatization disorder is before the age of 30. Somatization disorder affects women more frequently than men.

Individuals who have suffered from physical or sexual abuse in the past may have a higher risk of developing this disorder, although not everyone who is affected by somatization disorder has suffered from abuse. It is not know why these conditions are correlated.

Having a family member with somatization disorder can increase the risk of a female developing the disorder as well; men with an affected family member are not necessarily more prone to the disorder, but have a higher likelihood of developing personality disorders or substance abuse issues.

Cultural factors may also affect who develops somatization disorder (i.e., men or women) and what sort of symptoms they experience.

Symptoms of Somatization Disorder:

Symptoms tend to occur over the course of several weeks, months, and years. The symptoms of somatization disorder may not be explained by a medical condition or can simply be too excessive or extreme to be attributed to a medical condition.

While symptoms most commonly involve complaints of pain or issues with the nervous, reproductive, or digestive system, other possible symptoms associated with somatization disorder are as follows:

  • Chronic pain (such as headaches, backaches; abdominal, chest or join pains)
  • Amnesia
  • Bloating
  • Diarrhea
  • Swallowing problems
  • Loss of voice
  • Dizziness
  • Impotence
  • Nausea and/or vomiting
  • Shortness of breath
  • Vision problems or blindness
  • Paralysis or weakness of muscles
  • Heart palpitations
  • Food intolerance
  • Pain during intercourse or menstruation
  • Pain or burning sensation in sexual organs without intercourse
  • Heavy, irregular, or painful menstruation
  • Vomiting throughout the course of pregnancy

Some individuals with this disorder will tend to describe their symptoms in an emotional or noticeably dramatic manner. However, just because a person describes their ailments this way does not mean that they have somatoform disorder.

Stress can exacerbate symptoms. The cumulative effects of the physical symptoms can lead to the individual having problems functioning and maintaining a normal life.

Diagnosing Somatization Disorder:

Due to the varied physical symptoms, as well as a driving need to seek help, the individual may have several consultations with varying health providers and physicians.

However, due to the ongoing and often years-long symptoms, it is important that the individual consult with one primary care physician on a consistent basis. This doctor may diagnose somatization disorder after the patient has had years of observable symptoms that aren’t attributable to a specific medical disorder.

Prior to diagnosing somatization disorder, the doctor may test for the following diseases in order to rule them out as possible diagnoses:

Other tests may vary depending on which symptoms the individual has.

Criteria for Diagnosis of Somatization Disorder:

According to the DSM-IV, the diagnostic criteria for somatization disorder are as follows:

  • A history of somatic complaints over several years starting before age 30.
  • At least four different sites of pain on the body
  • At least two GI symptoms other than pain (nausea, bloating, diarrhea, vomiting, diarrhea, food intolerances)
  • One sexual symptom - a history of at least one sexual or reproductive symptom that is not pain (sexual indifference, erectile dysfunction, irregular menses, excessive menstrual bleeding)
  • One pseudoneurological symptom - a history of at least one symptom of deficit suggesting that the person has a neurological condition NOT related to pain (paralysis, localized weakness, impaired coordination, difficulty swallowing, urinary retention, hallucinations, loss of senses, seizures, amnesia) 

As well as either:

  1. Symptoms cannot be fully explained by another general medical condition or substance use
  2. If there is an associated medical condition, the physical complaints or social or occupational impairments are much more severe than generally expected based upon medical history, examination, or laboratory results.

The symptoms do not have to occur all at once, but may occur over the course of the disorder.

Treatment for Somatization Disorder:

There is no specific treatment for somatization disorder, because the illness is not due to any specific medical condition. However, treatment usually focuses on managing the physical symptoms of the disorder while treating possible mental health causes or symptoms or the disorder.

If your doctor suspects that you have somatization disorder, he or she may request evaluations for anxiety or depressive disorders from a mental health professional. Many people find that antidepressants or anti-anxiety medications can alleviate symptoms, but most who suffer from somatization disorder benefit from talk therapy (also known as psychotherapy) or cognitive behavioral therapy (CBT) with a mental health professional.

Therapy can help the individual learn to:

  • Gain awareness of pain triggers
  • Develop coping methods
  • Stay active despite pain

As stated above, it is important to have one doctor consistently observing the individual's symptoms over the years.

Tips for Living With Somatization Disorder:

Individuals with somatization disorder are especially sensitive to biases or stigmas related to mental health disorders. This is especially due to the fact that it can be difficult to obtain a specific diagnoses, or "validation," or the individual's condition. Some people may accuse the individual of faking their symptoms for different reasons. Some primary care physicians may not understand the cause of the symptoms and thus can be dismissive of the patient’s complaints.

It’s important for the individual and their family and friends to understand that someone with this disorder is NOT "faking" it. All medical and mental health professionals readily acknowledge that the physical symptoms are, indeed, very real. If your doctor does not, is dismissive of your symptoms, or says that you're "imagining" it, then it is time to find a new primary care physician that you trust.

Individuals with this disorder can sometimes develop dependencies on pain relievers or sedatives, which ultimately only complicate the diagnosis and treatment of the disorder. If you suspect you may be developing a dependency, consult with your doctor immediately.

Related Resource Pages on Band Back Together:

Body Dysmorphic Disorder

Conversion Disorder

Hypochondria

Stress

Anxiety

Pain

Somatoform Disorders

Additional Resources For Somatization Disorder:

Somatoform Disorder Info - A website with statistics and information on somatoform disorder, conversion disorder, body dysmorphic disorder, and more.

Campaign on Conversion Disorder - An ongoing conversation clarifying Conversion Disorder and its causes, symptoms and treatments. 

Disorders.org - This website is dedicated to somatoform disorders, including somatization. Information, resources, diagnosis, and treatment options are contained within.