Abstract
Somatization is a process in which there is inappropriate focus on physical symptoms and psychosocial problems are denied [1]. Somatization is highly prevalent in primary care where 20–30 % of patients fulfill criteria for somatoform disorders [2–4] and even more patients may present with medically unexplained symptoms of shorter duration [5]. In a general medical clinic in the USA, 84 % of presentations of common physical symptoms had no identified organic cause [5], and over half of new referrals to a Dutch medical outpatient clinic had symptoms that remained medically unexplained [6]. Despite its high prevalence, somatization often goes unrecognized [3, 7]. Somatizing patients suffer distress for a long time and seek treatment that results in disappointment because a correct diagnosis is not made by physicians. They doctor shop but cannot find a willing physician so they are called “medical orphans” [8]. They often make the complaint that “My symptoms are genuine, but everything is coming back negative” [9].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bass, C., & Benjamin, S. (1993). The management of chronic somatization. British Journal of psychiatry, 162, 472–480.
Toft, T., Fink, P., Oernboel, E., et al. (2005). Mental disorders in primary care: Prevalence and co-morbidity among disorders. Results from the functional illness in primary care (FIP) study. Psychological Medicine, 35, 1175–1184.
Fink, P., Sorensen, L., Engberg, M., et al. (1999). Somatization in primary care. Prevalence, health care utilization, and general practitioner recognition. Psychosomatics, 40, 330–338.
Arnold, I. A., de Waal, M. W., Eekhof, J. A., et al. (2006). Somatoform disorder in primary care: Course and the need for cognitive-behavioral treatment. Psychosomatics, 47, 498–503.
Kroenke, K., & Mangelsdorff, D. (1989). Common symptoms in ambulatory care: Incidence, evaluation, therapy and outcome. The American Journal of Medicine, 86, 262–266.
van Hemert, A. M., Hengeveld, M. W., Bolk, J. H., et al. (1993). Psychiatric disorders in relation to medical illness among patients of a general medical out-patient clinic. Psychological Medicine, 23, 167–173.
Goldberg, D., & Bridges, K. (1987). Screening for psychiatric illness in general practice: The general practitioner versus the screening questionnaire. The Journal of the Royal College of General Practitioners, 37, 15–18.
Aronowitz, R. A. (2001). When do symptoms become a disease? Annals of Internal Medicine, 134, 803–808.
Nettleton, S., Watt, I., O’Malley, L., et al. (2005). Understanding the narratives of people who live with medically unexplained illness. Patient Education and Counseling, 56, 205–210.
Price, J. R. (2000). Managing physical symptoms: The clinical assessment as treatment. Journal of Psychosomatic Research, 48, 1–10.
Koh, K. B. (2011). Stress and psychosomatic medicine (pp. 263–285). Seoul, Korea: Ilchokak.
Rhodes, L. A., McPhillips-Tangum, C. A., Markham, C., et al. (1999). The power of the visible: The meaning of diagnostic tests in chronic back pain. Social Science & Medicine, 48, 1189–1203.
Fink, P. (1992). Surgery and medical treatment in persistent somatizing patients. Journal of Psychosomatic Research, 36, 439–447.
Smith, G. R., Jr., Monson, R. A., & Ray, D. C. (1986). Patients with multiple unexplained symptoms. Their characteristics, functional health, and health care utilization. Archives of Internal Medicine, 146, 69–72.
Hahn, S. R., Thompson, K. S., Wills, T. A., et al. (1994). The difficult doctor-patient relationship: Somatization, personality and psychopathology. Journal of Clinical Epidemiology, 47, 647–657.
Sharpe, M., Mayou, R., Seagroatt, V., et al. (1994). Why do doctors find some patients difficult to help? The Quarterly Journal of Medicine, 87, 187–193.
Henningsen, P., Zipfel, S., & Herzog, W. (2007). Management of functional somatic syndromes. Lancet, 369, 946–955.
Aragones, E., Pinol, J. L., & Labad, A. (2007). Depression and physical comorbidity in primary care. Journal of Psychosomatic Research, 63, 107–111.
de Waal, M. W., Arnold, I. A., Eekhof, J. A., et al. (2008). Follow-up study on health care use of patients with somatoform, anxiety and depressive disorders in primary care. BMC Family Practice, 9, 5.
Gask, L., Sibbald, B., & Creed, F. (1997). Evaluating models of working at the interface between mental health services and primary care. The British Journal of Psychiatry, 170, 6–11.
Lieb, R., Meinlschmidt, G., & Araya, R. (2007). Epidemiology of the association between somatoform disorders and anxiety and depressive disorders: An update. Psychosomatic Medicine, 69, 860–863.
Hanel, G., Henningsen, P., Herzog, W., et al. (2009). Depression, anxiety, and somatoform disorders: Vague or distinct categories in primary care? Results from a large cross-sectional study. Journal of Psychosomatic Research, 67, 189–197.
Kessler, R. C. (2004). The epidemiology of dual diagnosis. Biological Psychiatry, 56, 730–737.
Faraone, A., Tsuang, M. T., & Tsuang, D. W. (1999). Genetics of mental disorders. A guide for students, clinicians and researchers. New York: Gilford Press.
Hotopf, M., Wadsworth, M., & Wessely, S. (2001). Is “somatisation” a defense against the acknowledgment of psychiatric disorder? Journal of Psychosomatic Research, 50, 119–124.
Williams, S., Weinman, J., Dale, J., et al. (1995). Patient expectations: What do primary care patients want from the GP and how far does meeting expectations affect patient satisfaction? Family Practice, 12, 193–201.
Matthews, D. A., Sledge, W. H., Lieberman, P. B., et al. (1987). Evaluation of intern performance by medical inpatients. The American Journal of Medicine, 35, 936–944.
Kerwick, S., Jones, R., Mann, A., et al. (1997). Mental health care training priorities in general practice. The British Journal of General Practice, 47, 225–227.
Reid, S., Whooley, D., Crayford, T., et al. (2001). Medically unexplained symptoms – GPs’ attitudes towards their cause and management. Family Practice, 18, 519–523.
Fink, P., Rosendal, M., & Toft, T. (2002). Assessment and treatment of functional disorders in general practice: The extended reattribution and management model – an advanced educational program for nonpsychiatric doctors. Psychosomatics, 43, 93–131.
Koh, K. B., Kim, D. K., Kim, S. Y., et al. (2008). The relation between anger management style, mood, and somatic symptoms in anxiety disorders and somatoform disorders. Psychiatry Research, 160, 372–379.
Maguire, G. P., Goldberg, D. P., Hobson, R. F., et al. (1984). Evaluating the teaching of a method of psychotherapy. The British Journal of Psychiatry, 144, 575–580.
Goldberg, D. P., Smith, C., Steele, J. J., et al. (1980). Training family doctors to recognize psychiatric illness with increased accuracy. Lancet, ii, 521–523.
Gask, L., Goldberg, D. P., Lesser, A. L., et al. (1988). Improving the psychiatric skills of the general practice trainee: An evaluation of a group training course. Medical Education, 22, 132–138.
Gask, L., Goldberg, D., Porter, R., et al. (1989). The treatment of somatization: Evaluation of a teaching package with general practice trainees. Journal of Psychosomatic Research, 33, 697–703.
Craig, T. K. J., & Boardman, A. P. (1990). Somatization in primary care settings. In C. Bass (Ed.), Somatization: Physical symptoms and psychological illness. Oxford: Blackwell.
Grol, R. (1988). To heal or to harm. The prevention of somatic fixation in general practice. London: Royal College of General Practitioners.
Gorlin, R., & Zucker, H. D. (1983). Physician’s reactions to patients: A key to teaching humanistic medicine. The New England Journal of Medicine, 308, 1059–1063.
Groves, J. E. (1978). Taking care of the hateful patient. The New England Journal of Medicine, 298, 883–887.
Mayou, R. A., Bass, C., & Sharpe, M. (1995). Treatment of functional somatic symptoms. Oxford: Oxford University Press.
Stewart, M., Brown, J., Weston, W., et al. (2003). Patient-centered medicine transforming the clinical method. Oxford: Radcliffe Medical Press.
Salmon, P. (2000). Patients who present with physical symptoms in the absence of physical pathology: A challenge to existing models of doctor-patient interaction. Patient Education and Counseling, 39, 105–113.
Salkovskis, P. M. (1989). Somatic problems. In K. Hawton, P. M. Salkovskis, J. Kirk, et al. (Eds.), Cognitive behavior therapy for psychiatric problems. A practical guide. Oxford: Oxford University Press.
Sharpe, M., Peveler, R., & Mayou, R. (1992). The psychological treatment of patients with functional somatic symptoms: A practical guide. Journal of Psychosomatic Research, 36, 515–529.
Thomas, K. B. (1987). General practice consultations: Is there any point in being positive? BMJ, 294, 1200–1202.
Fitzpatrick, R. M., & Hopkins, A. (1981). Referrals to neurologists for headaches not due to structural disease. Journal of Neurology, Neurosurgery, and Psychiatry, 44, 1061–1067.
van Dulmen, A., Fennis, J. F., Mokkink, H. G., et al. (1995). Doctor-dependent changes in complaint-related cognitions and anxiety during medical consultations in functional abdominal complaints. Psychological Medicine, 25, 1011–1018.
Sharpe, M., & Bass, C. (1992). Pathophysiological mechanisms in somatization. International Review of Psychiatry, 4, 81–97.
Morriss, R., Gask, L., Ronalds, C., et al. (1999). Clinical and patient satisfaction outcomes of a new treatment for somatized mental disorder taught to general practitioners. The British Journal of General Practice, 49, 262–267.
Morriss, R. K., & Gask, L. (2002). Treatment of patients with somatized mental disorder: Effects of reattribution training on outcomes under the direct control of the family doctor. Psychosomatics, 43, 394–399.
Rosendal, M., Olesen, F., Fink, P., et al. (2007). A randomized controlled trial of brief training in the assessment and treatment of somatization in primary care: Effects on patient outcome. General Hospital Psychiatry, 29, 364–373.
Kroenke, K., Taylor-Vaisey, A., Dietrich, A. J., et al. (2000). Interventions to improve provider diagnosis and treatment of mental disorders in primary care. A critical review of the literature. Psychosomatics, 41, 39–52.
Kroenke, K., & Swindle, R. (2000). Cognitive-behavioral therapy for somatization and somatic symptoms: A critical review of controlled clinical trials. Psychotherapy and Psychosomatics, 69, 205–215.
Smith, G. R., Jr., Rost, K., & Kashner, T. M. (1995). A trial of the effect of a standardized psychiatric consultation on health outcomes and costs in somatizing patients. Archives of General Psychiatry, 52, 238–243.
Speckens, A. E. M., van Hemert, A. M., Spinhoven, P., et al. (1995). Cognitive behavioral therapy for medically unexplained physical symptoms: A randomized controlled trial. BMJ, 311, 1328–1332.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Koh, K.B. (2013). An Effective Approach to Somatization Assessment and Management. In: Koh, K. (eds) Somatization and Psychosomatic Symptoms. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7119-6_9
Download citation
DOI: https://doi.org/10.1007/978-1-4614-7119-6_9
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-7118-9
Online ISBN: 978-1-4614-7119-6
eBook Packages: Behavioral ScienceBehavioral Science and Psychology (R0)