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Gastrointestinal (GI) complaints, such as nausea, bloating, diarrhea, and sensitivities to certain foods are common, and at least two different GI symptoms are required for the diagnosis. Sexual or reproductive symptoms, including pain during intercourse, menstrual problems, and erectile dysfunctionare also necessary features for a diagnosis for somatization disorder. Other frequent symptoms are headaches, pain in the back or joints, difficulty swallowing or speaking, and urinary retention. To qualify for the diagnosis, at least one symptom must resemble a neurological disorder, such as seizures, problems with coordination or balance, or paralysis.
According to the DSM-IV-TR, somatization disorder is rare in males in the United States, although higher rates are seen among males from some cultural and ethnic groups. The DSM-IV-TRestimates that between 0.2% and 2% of women, and less than 0.2% of men, suffer from somatization disorder in the U.S. Sex ratios may arise from different rates of seeking treatment. However, studies of unexplained somatic symptoms in the general population find less striking differences in rates between men and women. Specific symptoms may vary across cultures. For example, the DSM-IV-TRnotes that the sensation of worms in the head or ants crawling under the skin are sometimes reported in African and South Asian countries, but rarely seen in North American patients.
To receive a diagnosis of somatization disorder, the individual must have a history of multiple physical complaints that began before age 30 and that continued for several years (DSM-IV-TR). These symptoms must cause significant impairment to social, occupational or other areas of functioning—or lead the patient to seek medical treatment.
Each of the following four criteria must be met.
If a thorough medical evaluation reveals no evidence of an underlying medical- or drug- or medication-induced condition, the diagnosis of somatization disorder is likely. People with genuine medical conditions can qualify for the diagnosis if the level of functional impairment reported is more than would be expected based on medical findings. The symptoms must not be intentionally produced. If the patient is feigning symptoms, a diagnosis of factitious disorderor malingeringwould most likely be considered.
Author Info: Danielle Barry M.S., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Mental Disorders, 2003This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.
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