Somatization

Last updated: Wed, Jul 31, 2024

Somatization is a poor relation of the psychogenic pain disorders. It is described as a tendency to experience and communicate somatic distress and symptoms unaccounted for by pathological finding[,] to attribute them to physical illness[,] and to seek medical help for them. Since the symptoms are unaccounted for, a diagnosis of somatization could become a diagnosis of conversion disorder. (You might wonder why it should be a disorder to experience and communicate distress, and so might I.)

A review of 57 relevant studies found that somatization, as measured by questionnaires, was correlated with chronic pain, and that more pain correlated with more somatization. Successful treatment of the pain reduced somatization. Another review found that studies into somatization rarely investigate whether the symptoms are in fact unaccounted for.1

This isn't to say that somatization is unworthy of notice. Among chronic pain patients, higher somatization correlates with a lower perceived quality of life, with major depression, and with alcohol dependence. In the field of pain medicine, however, where so many factors are associated with so many others and effective treatments are largely lacking, it is important that the medical and research communities identify and focus on those interventions that clearly are most likely to be effective.