Somatization disorder: a practical review.

OBJECTIVE This paper reviews the present state of knowledge on the etiology, prevalence, diagnosis, and treatment of somatization disorder (SD). METHOD A comprehensive review of the literature on SD is described under the above headings. RESULTS SD is a common condition that is not well managed by many physicians. Patients with SD get caught between the cracks of the health care system, with expensive consequences. SD is a psychiatric disorder, but patients are reluctant to see and be treated by psychiatrists. They frequently are managed by nonpsychiatric physicians who have limited understanding of the condition. Cognitive-behavioural therapy (CBT) is the most efficacious treatment in SD, although antidepressants and supportive psychotherapy also have a role for some patients. CONCLUSIONS A cadre of clinicians with training in the theory and practice of CBT for SD is required. They need to be based both in the community and in tertiary health care centres, where most patients with this condition are located.