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Somatic symptom disorder

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+#REDIRECT [[Somatic symptom disorder]]
-{{short description|Mental disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic symptoms}}
-{{Infobox medical condition (new)
-| name            = Somatization disorder
-| synonyms        = [[Paul Briquet|Briquet's]] syndrome
-| image           = File:Somatic symptom disorder.webm
-| caption         =
-| pronounce       =
-| field           = [[Psychiatry]], [[clinical psychology]]
-| symptoms        = Variable physical symptoms that can include [[headaches]], generalized pain, changes in [[bowel movements]], [[fatigue]], [[weakness]], [[dyspareunia|pain with sex]],<ref>https://my.clevelandclinic.org/health/diseases/17976-somatic-symptom-disorder-in-adults</ref> [[mental distress|distress]] about these symtoms
-| complications   =
-| onset           =
-| duration        =
-| types           =
-| causes          =
-| risks           = [[Major depressive disorder|Depression]], [[anxiety disorder|anxiety]], [[substance abuse]], [[parental neglect]], [[abuse]]
-| diagnosis       =
-| differential    = [[Conversion disorder]], real physical illness
-| prevention      =
-| treatment       = [[Cognitive behavioral therapy]], [[electroconvulsive therapy]]
-| medication      =
-| prognosis       =
-| frequency       =
-| deaths          =
-|alt=}}
-'''Somatization disorder''' is a [[mental disorder|mental]] and [[Abnormal behavior|behavioral]] [[disease#disorder|disorder]]<ref>Drs; {{cite web |url=https://www.who.int/classifications/icd/en/bluebook.pdf |title= The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines |first1=Norman|last1= Sartorius|author-link=Norman Sartorius|last2=  Henderson|first2=A.S.|last3= Strotzka|first3=H.|last4= Lipowski|first4=Z. |last5= Yu-cun|first5=Shen|last6=You-xin|first6=Xu |last7=Strömgren|first7=E. |last8= Glatzel|first8=J. |last9= Kühne|first9=G.-E.|last10= Misès|first10=R.|last11=Soldatos|first11=C.R. |last12= Pull|first12=C.B.|last13= Giel|first13=R.|last14= Jegede|first14=R.|last15=Malt|first15=U. |last16= Nadzharov|first16=R.A.|last17=  Smulevitch|first17=A.B.|last18= Hagberg|first18=B.|last19=  Perris|first19=C.|last20= Scharfetter|first20=C. |last21= Clare|first21=A. |last22= Cooper|first22=J.E. |last23= Corbett|first23=J.A. |last24=Griffith Edwards |first24=J. |last25= Gelder|first25=M.|last26= Goldberg|first26=D.|last27= Gossop|first27=M.|last28= Graham|first28=P.|last29=Kendell|first29=R.E. |last30= Marks|first30=I.|last31= Russell|first31=G.|last32= Rutter|first32=M.|last33=  Shepherd|first33=M.|last34=  West |first34=D.J.|last35= Wing |first35=J. |last36= Wing|first36=L.|last37= Neki|first37=J.S. |last38= Benson|first38=F.|last39= Cantwell|first39=D. |last40=Guze|first40=S. |last41= Helzer|first41=J.|last42=  Holzman|first42=P.|last43=  Kleinman|first43=A.|last44=Kupfer|first44=D.J.|last45= Mezzich|first45=J. |last46= Spitzer|first46=R. |last47=Lokar |first47=J. |website=www.who.int [[World Health Organization]] |publisher=[[Microsoft Word]]  |agency=bluebook.doc |page=116 |access-date=23 June 2021 |url-status=live|via=[[Microsoft Bing]]}}</ref> characterized by recurring, multiple, and current, clinically significant complaints about [[somatic nervous system|somatic]] symptoms. It was recognized in the [[DSM-IV-TR]] classification system, but in the latest version [[DSM-5]], it was combined with [[undifferentiated somatoform disorder]] to become ''[[somatic symptom disorder]]'', a diagnosis which no longer requires a specific number of somatic symptoms.<ref name=highlights>{{cite web|title=Highlights of Changes from DSM-IV-TR to DSM-5|url=http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdf|date=May 17, 2013|publisher= [[American Psychiatric Association]] |access-date=September 6, 2013}}</ref> [[ICD-10]], the latest version of the [[International Statistical Classification of Diseases and Related Health Problems]], still includes somatization syndrome.<ref name=icd10>{{cite web|url=http://apps.who.int/classifications/icd10/browse/2015/en#/F45.0|title=ICD-10 Version:2015|access-date=2015-05-23}}</ref>
+{{R from merge}}
-==Criteria==
-===DSM-5===
-In the [[DSM-5]] the disorder has been renamed [[somatic symptom disorder]] (SSD), and includes SSD with predominantly somatic complaints (previously referred to as somatization disorder), and SSD with pain features (previously known as [[pain disorder]]).<ref>{{cite book|last=Association|first=American Psychiatric|title=Diagnostic and Statistical Manual of Mental DisordersAmerican Psychiatric Associati.|publisher=AMERICAN PSYCHIATRIC PUBLISHING|location=Arlington|isbn=978-0890425558|edition=5th|year=2013|url-access=registration|url=https://archive.org/details/diagnosticstatis0005unse}}</ref>
-===DSM-IV-TR===
-The [[DSM-IV-TR]] diagnostic criteria are:<ref name=DSM4TR>{{cite book |author= American Psychiatric Association|title=Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR |publisher=American Psychiatric Association |location=Washington, DC |year=2000|pages=486–490 |isbn=978-0-89042-025-6|title-link=DSM-IV-TR }}</ref>
-*A history of somatic complaints over several years, starting prior to the age of 30.
-*Such symptoms cannot be fully explained by a general medical condition or substance use or, when there is an associated medical condition, the impairments due to the somatic symptoms are more severe than generally expected.
-*Complaints are not feigned as in [[malingering]] or [[factitious disorder]].
-The symptoms do not all have to occur at the same time, but may occur over the course of the disorder. A somatization disorder itself is chronic but fluctuating that rarely remits completely. A thorough physical examination of the specified areas of complaint is critical for somatization disorder diagnosis. Medical examination would provide object evidence of subjective complaints of the individual.<ref name=DSM4TR/>
-Diagnosis of somatization disorder is difficult because it is hard to determine to what degree psychological factors are exacerbating subjective feelings of pain. For instance, [[chronic pain]] is common in 30% of the U.S. population,<ref name="pmid17209691">{{cite journal | vauthors = Hoffman BM, Papas RK, Chatkoff DK, Kerns RD | title = Meta-analysis of psychological interventions for chronic low back pain | journal = Health Psychol | volume = 26 | issue = 1 | pages = 1–9 | date = January 2007 | pmid = 17209691 | doi = 10.1037/0278-6133.26.1.1 }}</ref> making it difficult to determine whether or not the pain is due to predominately psychological factors.
-===ICD-10===
-In [[ICD-10]], the latest version of the [[International Statistical Classification of Diseases and Related Health Problems]], somatization syndrome is described as:<ref name=icd10/>
-{{quote|''"The main features are multiple, recurrent and frequently changing physical symptoms of at least two years duration. Most patients have a long and complicated history of contact with both primary and specialist medical care services, during which many negative investigations or fruitless exploratory operations may have been carried out. Symptoms may be referred to any part or system of the body. The course of the disorder is chronic and fluctuating, and is often associated with disruption of social, interpersonal, and family behaviour."''}}
-ICD-10 also includes the following subgroups of somatization syndrome:<ref name=icd10/>
-*[[Undifferentiated somatoform disorder]].
-*[[Hypochondriasis]].
-*[[Somatoform autonomic dysfunction]].
-*Persistent somatoform pain disorder.
-*Other somatoform disorders, such ones predominated by [[dysmenorrhoea]], [[dysphagia]], [[pruritus]] and [[torticollis]].
-*Somatoform disorder, unspecified.
-==Cause==
-Although somatization disorder has been studied and diagnosed for more than a century, there is debate and uncertainty regarding its pathophysiology. Most current explanations focus on the concept of a misconnection between the mind and the body. Genetics probably contributes a very small amount to development of the disorder.<ref name="pmid18578896">{{cite journal | vauthors = Kato K, Sullivan PF, Evengård B, Pedersen NL | title = A population-based twin study of functional somatic syndromes | journal = Psychol Med | volume = 39 | issue = 3 | pages = 497–505 | date = March 2009 | pmid = 18578896 | pmc = 3947533 | doi = 10.1017/S0033291708003784 }}</ref>
-One of the oldest explanations for somatization disorder advances the theory that it is a result of the body's attempt to cope with emotional and psychological stress. The theory states that the body has a finite capacity to cope with psychological, emotional, and social distress, and that beyond a certain point symptoms are experienced as physical, principally affecting the digestive, nervous, and reproductive systems. There are many different feedback systems where the mind affects the body; for instance, headaches are known to be associated with psychological factors,<ref name="pmid19556046">{{cite journal | vauthors = Martin PR, MacLeod C | title = Behavioral management of headache triggers: Avoidance of triggers is an inadequate strategy | journal = Clin Psychol Rev | volume = 29 | issue = 6 | pages = 483–95 | date = August 2009 | pmid = 19556046 | doi = 10.1016/j.cpr.2009.05.002 }}</ref> and stress and the hormone [[cortisol]] are known to have a negative impact on immune functions. This might explain why somatization disorders are more likely in people with [[irritable bowel syndrome]], and why patients with SSD are more likely to have a mood or anxiety disorder.<ref name="DSM4TR"/> There is also a much increased incidence of SSD in people with a history of [[physical abuse|physical]], [[emotional abuse|emotional]] or [[sexual abuse]].<ref>{{cite journal |author1=Pribor E. F. |author2=Yutzy S. H. |author3=Dean J. T. |author4=Wetzel R. D. | year = 1993 | title = Briquet's Syndrome, dissociation and abuse | journal = American Journal of Psychiatry | volume = 150 | issue = 10| pages = 1507–1511 | doi=10.1176/ajp.150.10.1507|pmid=8379555 |citeseerx=10.1.1.474.4552 }}</ref>
-Another hypothesis for the cause of somatization disorder is that people with the disorder have heightened sensitivity to internal physical sensations and pain.<ref name="pmid22149912">{{cite journal | vauthors = Katzer A, Oberfeld D, Hiller W, Gerlach AL, Witthöft M | title = Tactile perceptual processes and their relationship to somatoform disorders | journal = J Abnorm Psychol | volume = 121 | issue = 2 | pages = 530–43 | date = May 2012 | pmid = 22149912 | doi = 10.1037/a0026536 | citeseerx = 10.1.1.702.448 }}</ref>  A biological sensitivity to somatic feelings could predispose a person to developing SSD. It is also possible that a person's body might develop increased sensitivity of nerves associated with pain and those responsible for pain perception, as a result of chronic exposure to stressors.<ref name="FarrugiaFetter">{{cite journal|vauthors = Farrugia D, Fetter H|title=Chronic pain: Biological understanding and treatment suggestions for mental health counselors|journal=Journal of Mental Health Counseling|year=2009|volume=31|issue=3|pages=189–200|doi=10.17744/mehc.31.3.f2l6hk4834p82483}}</ref>
-Cognitive theories explain somatization disorder as arising from negative, distorted, and catastrophic thoughts and reinforcement of these cognitions. Catastrophic thinking could lead a person to believe that slight ailments, such as mild muscle pain or shortness of breath, are evidence of a serious illness such as cancer or a tumor. These thoughts can then be reinforced by supportive social connections. A spouse who responds more to his or her partner's pain cues makes it more likely that he or she will express greater pain.<ref name="pmid8995045">{{cite journal | vauthors = Williamson D, Robinson ME, Melamed B | title = Pain behavior, spouse responsiveness, and marital satisfaction in patients with rheumatoid arthritis | journal = Behav Modif | volume = 21 | issue = 1 | pages = 97–118 | date = January 1997 | pmid = 8995045 | doi = 10.1177/01454455970211006  }}</ref> Children of parents who are preoccupied or overly attentive to the somatic complaints of their children are more likely to develop somatic symptoms.<ref>{{cite journal| vauthors = Watt MC, O'Connor RM, Stewart SH, Moon EC, Terry L|title=Specificity of childhood learning experiences in relation to anxiety sensitivity and illness/injury sensitivity: Implications for health anxiety and pain|journal=Journal of Cognitive Psychotherapy|year=2008|volume=22|issue=2|pages=128–143|doi=10.1891/0889-8391.22.2.128|citeseerx=10.1.1.579.8368}}</ref> Severe cognitive distortions can make a person with SSD limit the behaviors he or she engages in, and cause increased disability and impaired functioning.<ref name="minddisorders.com">{{cite web |url=http://www.minddisorders.com/Py-Z/Somatization-disorder.html |title=Somatization disorder |author=<!--Not stated--> |website=Encyclopedia of Mental Disorders |access-date= October 10, 2008}}</ref>
-===Neuroimaging evidence===
-A recent review of the cognitive–affective neuroscience of somatization disorder suggested that [[catastrophization]] in patients with somatization disorders tends to present a greater vulnerability to pain. The relevant brain regions include the dorsolateral prefrontal, insular, rostral anterior cingulate, premotor, and parietal cortices.<ref name="pmid18496475">{{cite journal | vauthors = Stein DJ, Muller J | title = Cognitive-affective neuroscience of somatization disorder and functional somatic syndromes: reconceptualizing the triad of depression-anxiety-somatic symptoms | journal = CNS Spectr | volume = 13 | issue = 5 | pages = 379–84 | date = May 2008 | pmid = 18496475 | doi = 10.1017/S1092852900016540 }}</ref><ref name="pmid19553880">{{cite journal | vauthors = García-Campayo J, Fayed N, Serrano-Blanco A, Roca M | title = Brain dysfunction behind functional symptoms: neuroimaging and somatoform, conversive, and dissociative disorders | journal = Curr Opin Psychiatry | volume = 22 | issue = 2 | pages = 224–31 | date = March 2009 | pmid = 19553880 | doi = 10.1097/YCO.0b013e3283252d43 }}</ref>
-==Treatments==
-To date, [[cognitive behavioral therapy]] (CBT) is the best established treatment for a variety of somatoform disorders including somatization disorder.<ref name="pmid16864762">{{cite journal | vauthors = Allen LA, Woolfolk RL, Escobar JI, Gara MA, Hamer RM | title = Cognitive-behavioral therapy for somatization disorder: a randomized controlled trial | journal = Arch. Intern. Med. | volume = 166 | issue = 14 | pages = 1512–8 | date = July 2006 | pmid = 16864762 | doi = 10.1001/archinte.166.14.1512 | doi-access = free }}</ref><ref name="pmid15560311">{{cite journal | vauthors = Mai F | title = Somatization disorder: a practical review | journal = Can J Psychiatry | volume = 49 | issue = 10 | pages = 652–62 | date = October 2004 | pmid = 15560311 | doi = 10.1177/070674370404901002 | doi-access = free }}</ref><ref name=Kurt>{{cite journal | vauthors = Kroenke K | title = Efficacy of treatment for somatoform disorders: a review of randomized controlled trials | journal = Psychosom Med | volume = 69 | issue = 9 | pages = 881–8 | date = December 2007 | pmid = 18040099 | doi = 10.1097/PSY.0b013e31815b00c4 }}</ref> CBT aims to help patients realize their ailments are not catastrophic and to enable them to gradually return to activities they previously engaged in, without fear of "worsening their symptoms". Consultation and collaboration with the [[primary care physician]] also demonstrated some effectiveness.<ref name="Kurt"/><ref name="pmid3084975">{{cite journal | vauthors = Smith GR, Monson RA, Ray DC | title = Psychiatric consultation in somatization disorder. A randomized controlled study | journal = N. Engl. J. Med. | volume = 314 | issue = 22 | pages = 1407–13 | date = May 1986 | pmid = 3084975 | doi = 10.1056/NEJM198605293142203 }}</ref> The use of [[antidepressant]]s is preliminary but does not yet show conclusive evidence.<ref name="Kurt"/><ref name="pmid12934972">{{cite journal | vauthors = Stahl SM | title = Antidepressants and somatic symptoms: therapeutic actions are expanding beyond affective spectrum disorders to functional somatic syndromes | journal = J Clin Psychiatry | volume = 64 | issue = 7 | pages = 745–6 | date = July 2003 | pmid = 12934972  }}</ref> [[Electroconvulsive shock therapy]] (ECT) has been used in treating somatization disorder among the elderly; however, the results were still debatable with some concerns around the side effects of using ECT.<ref name="pmid3042587">{{cite journal | vauthors = Zorumski CF, Rubin EH, Burke WJ | title = Electroconvulsive therapy for the elderly: a review | journal = Hosp Community Psychiatry | volume = 39 | issue = 6 | pages = 643–7 | date = June 1988 | pmid = 3042587 | doi = 10.1176/ps.39.6.643 }}</ref> Overall, psychologists recommend addressing a common difficulty in patients with somatization disorder in the reading of their own emotions.  This may be a central feature of treatment; as well as developing a close collaboration between the GP, the patient and the mental health practitioner.<ref name = Kenny>{{cite journal |vauthors=Kenny M, Egan J| date = February 2011 | title = Somatization disorder: What clinicians need to know | journal = The Irish Psychologist | volume = 37 | issue = 4 | pages = 93–96 | url = http://www.lenus.ie/hse/bitstream/10147/121822/1/SomatizationDis.pdf | access-date = 9 December 2011 }}</ref>
-==Epidemiology==
-Somatization disorder is estimated to occur in 0.2% to 2% of females,<ref name="pmid3598478">{{cite journal | vauthors = deGruy F, Columbia L, Dickinson P | title = Somatization disorder in a family practice | journal = J Fam Pract | volume = 25 | issue = 1 | pages = 45–51 | date = July 1987 | pmid = 3598478  }}</ref><ref name="pmid3952541">{{cite journal | vauthors = Lichstein PR | title = Caring for the patient with multiple somatic complaints | journal = South. Med. J. | volume = 79 | issue = 3 | pages = 310–4 | date = March 1986 | pmid = 3952541 | doi = 10.1097/00007611-198603000-00013 }}</ref> and 0.2% of males.
-There are cultural differences in the prevalence of somatization disorder. For example, somatization disorder and symptoms were found to be significantly more common in [[Puerto Rico]].<ref>{{Cite journal| vauthors = Canino G, Bird H, Rubio-Stipec M, Bravo M |title= The epidemiology of mental disorders in the adult population of Puerto Rico |journal= Revista Interamericana de Psicologia. |volume=34 |issue=1X |pages= 29–46 |year=2000}}</ref> In addition the diagnosis is also more prevalent among African Americans and those with less than a high school education or lower socioeconomic status.<ref name="pmid16899963">{{cite journal | vauthors = Noyes R, Stuart S, Watson DB, Langbehn DR | title = Distinguishing between hypochondriasis and somatization disorder: a review of the existing literature | journal = Psychother Psychosom | volume = 75 | issue = 5 | pages = 270–81 | date = 2006 | pmid = 16899963 | doi = 10.1159/000093948  }}</ref>
-There is usually co-morbidity with other psychological disorders, particularly [[mood disorders]] or [[anxiety disorders]].<ref name=DSM4TR/><ref>{{Cite journal|author1=Lieb, Roselind |author2=Meinlschmidt, Gunther |author3=Araya, Ricardo. |title=Epidemiology of the association between somatoform disorders and anxiety and depressive disorders: An update |journal=Psychosomatic Medicine |volume=69 |issue=9 |pages=860–863 |year=2007 |doi=10.1097/psy.0b013e31815b0103|pmid=18040095 }}</ref> Research also showed comorbidity between somatization disorder and [[personality disorder]]s, especially [[Antisocial personality disorder|antisocial]], [[Borderline personality disorder|borderline]], [[Narcissistic personality disorder|narcissistic]], [[Histrionic personality disorder|histrionic]], [[Avoidant personality disorder|avoidant]], and [[Dependent personality disorder|dependent]] personality disorder.<ref>{{Cite journal|author1=Bornstein, Robert F |author2=Gold, Stephanie H |title=Comorbidity of personality disorders and somatization disorder: A meta-analytic review |journal=Journal of Psychopathology and Behavioral Assessment |volume=30 |issue=2 |pages=154–161 |year=2008 |doi=10.1007/s10862-007-9052-2}}</ref>
-About 10-20 percent of female first degree relatives also have somatization disorder and male relatives have increased rates of alcoholism and sociopathy.<ref>{{cite book|last=Stern|first=Theodore|title=Massachusetts General Hospital comprehensive clinical psychiatry|url=https://archive.org/details/massachusettsgen00mdth_150|url-access=limited|year=2008|publisher=Mosby/Elsevier|location=Philadelphia, PA|isbn=9780323047432|page=[https://archive.org/details/massachusettsgen00mdth_150/page/n336 323]|edition=1st}}</ref>
-==See also==
-{{Portal|Psychology}}
-*[[Body-centred countertransference]]
-*[[Culture-bound syndrome]]
-*[[Hypochondriasis]]
-*[[Medically unexplained symptoms]]
-*[[Psychosomatic illness]]
-==References==
-{{Reflist}}
-== External links ==
-{{Medical resources
-| DiseasesDB      = 1645
-| ICD10           = {{ICD10|F|45|0|f|40}}
-| ICD9            = {{ICD9|300.81}}
-| ICDO            =
-| OMIM            =
-| eMedicineSubj   = ped
-| eMedicineTopic  = 3015
-| MeshID          = D013001
-| SNOMED CT       = 397923000
-}}
-{{Mental and behavioural disorders|selected = neurotic}}
-[[Category:Somatic symptom disorders]]
-[[de:Somatoforme Störung]]
-[[is:Geðvefrænir sjúkdómar]]
-[[fi:Somatisaatiohäiriö]]