A review of the differences between somatizing and psychologizing patients in primary care

Abstract

Objective: This article reviews all published studies on somatizing and psychologizing patients in primary care, according to Bridges and Goldberg's criteria [1].

Method: A review of the Medline base from 1985 to 1998 was carried out.

Results: Somatization is a concept valid, reliable, and stable over time. There are no differences between somatizers and psychologizers in sociodemographics, social problems or past medical and psychiatric history. The main clinical and diagnostic difference is a predominance of depressive symptoms and disorders in psychologizers. Finally, the most remarkable differences between somatizers and psychologizers are found in personality traits, such as attribution of somatic symptoms. However, some traits considered important in the outcome of somatizers, such as hypochondriasis or locus of control, show no differences between both groups of patients.

Conclusion: Contrary to what was expected, the comparison between these two groups of patients give few clues for the etiology and treatment of somatization. Follow-up studies should be the main source of data to answer these questions.