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Somatization: Epidemiology, pathogenesis, clinical features, medical evaluation, and diagnosis

Donna B Greenberg, MD
Section Editor
Joel Dimsdale, MD
Deputy Editor
David Solomon, MD


Somatization is a syndrome of physical symptoms that are distressing and may not be fully explained by a known medical condition after appropriate investigation. In addition, the symptoms may be caused or exacerbated by anxiety, depression, and interpersonal conflicts, and it is common for somatization, depression, and anxiety to all occur together [1-5]. Somatization can be conscious or unconscious and may be influenced by a desire for the sick role or for personal gain [5].

Somatization often occurs in primary care patients [4]. It increases use of medical services independent of any accompanying psychiatric or nonpsychiatric disorder and leads to frustration in both the patient and the clinician [3,6-9].

This topic reviews the following issues related to somatization: epidemiology, pathogenesis, clinical features, medical evaluation, and diagnosis of specific disorders. Treatment of somatization and prognosis are discussed separately. (See "Somatization: Treatment and prognosis".)


The term "somatization" as used in this topic refers to a syndrome consisting of physical symptoms that cause substantial distress and psychosocial impairment, and are not explained by a known general medical disease. Somatization has also been referred to as medically unexplained symptoms and functional somatic symptoms.

Somatization is an overarching term that encompasses many different illnesses and terms including “somatoform disorders,” which is a group of disorders that are recognized in the World Health Organization's International Classification of Diseases-10th Revision (ICD-10) [10], and were previously described in the American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR) (table 1) [11]. (See 'Somatoform disorders' below.)

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Literature review current through: Nov 2017. | This topic last updated: Jan 27, 2016.
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