The problem of somatization in family practice

Abstract

Patients with somatization disorder, in the full-blown or subsyndromal form, are high users of health care and often receive expensive, unnecessary tests and treatments. Their multiple somatic complaints do not have a biomedical basis but, instead, reflect underlying emotional conflicts that the patient is unable to face. Treatment of these patients is difficult, with no approach showing a good cure rate. However, if the underlying psychosocial etiology is understood and modest goals are set, much can be done to limit the problem and reduce symptoms. Management includes setting clear limits on the patient's access to the physician, while maintaining an empathetic and supportive doctor-patient relationship. Behavioral cognitive psychotherapy and short-term intensive psychotherapy may help the patient understand the underlying conflicts and thereby reduce the symptoms.