Briquets syndrome

Definition

Somatization disorder is a chronic condition in which there are numerous physical complaints. These complaints can last for years, and result in substantial impairment. The physical symptoms are caused by psychological problems, and no underlying physical problem can be identified.

Alternative Names

Causes

The disorder is marked by multiple physical complaints that persist for years, involving any body system. Most frequently, the complaints involve chronic pain and problems with the digestive system, the nervous system, and the reproductive system. The disorder usually begins before the age of 30 and occurs more often in women than in men. Recent research has shown higher percentages of this disorder in people with irritable bowel syndrome and chronic pain patients.

Somatization disorder is highly stigmatized, and patients are often dismissed by their physicians as having problems that are "all in your head." However, as researchers study the connections between the brain, the digestive system, and the immune system, somatization disorders are becoming better understood. They should not be seen as "faked" conditions that the patient could end if he or she chose to do so.

The symptoms are generally severe enough to interfere with work and relationships and lead the person to visit the doctor and even take medication. A lifelong history of "sickliness" is often present. However, despite thorough investigation, no specific underlying physical cause is ever identified to account for the symptoms. Stress often worsens the symptoms.

Symptoms

Some of the numerous symptoms that can occur with somatization disorder include:

• Vomiting
• Abdominal pain
• Nausea
• Bloating
• Diarrhea
• Pain in the legs or arms
• Back pain
• Joint pain
• Pain during urination
• Headaches
• Shortness of breath
• Palpitations
• Chest pain
• Dizziness
• Amnesia
• Difficulty swallowing
• Vision changes
• Paralysis or muscle weakness
• Sexual apathy
• Pain during intercourse
• Impotence
• Painful menstruation
• Irregular menstruation
• Excessive menstrual bleeding

It is important to note that many of these symptoms also occur in other medical and psychiatric disorders. If you experience any of these symptoms, be sure to work with your doctor to rule out possible causes before a diagnosis of somatization disorder is made.

Exams and Tests

• A thorough physical examination and diagnostic tests are performed to rule out physical causes. Which tests are done depends on the symptoms present.
• A psychological evaluation is performed to rule out related disorders.

Treatment

Once other causes have been ruled out and a diagnosis of somatization disorder is secured, the goal of treatment is to help the person learn to control the symptoms. There is often an underlying mood disorder which can respond to conventional treatment, such as antidepressant medications. Unfortunately, persons with this disorder rarely admit that it can be caused, at least in part, by mental health problems, and will usually refuse psychiatric treatment.

A supportive relationship with a sympathetic health care provider is the most important aspect of treatment. Regularly scheduled appointments should be maintained to review symptoms and the person's coping mechanisms. Test results should be explained.

You should not be told that your symptoms are imaginary. With the current understanding of the complex interactions between the brain and other body parts, scientists recognize that true physical symptoms can result from psychological stress.

Possible Complications

• Complications may result from invasive testing and from multiple evaluations that are performed while looking for the cause of the symptoms.
• A dependency on pain relievers or sedatives may develop.
• A poor relationship with the health care provider seems to worsen the condition, as does evaluation by many providers.

When to Contact a Medical Professional

A good relationship with a consistent primary health care provider is helpful. Call for an appointment if there is a significant change in symptoms.

Prevention

Counseling or other psychological interventions may help people who are prone to somatization learn other ways of dealing with stresses. This may help reduce the intensity of the symptoms.