Somatization: theories and research

Article Abstract:

Somatization refers to a type of disorder where the patient expresses physical complaints, but no organic reason can be found to account for the symptoms. Functional somatic symptoms often take the form of fatigue and gastrointestinal or urinary complaints. There is currently no single theory that adequately explains this condition, and it is believed that many factors may be responsible. A summary has been presented which discusses the variety of current theories of the cause of somatization; some studies provide support to theories, and some do not. Genetic factors have been identified which may predispose an individual to develop somatoform syndromes; other syndromes may arise from early childhood stress, such as living with an alcoholic father. A number of studies have shown a relationship between anxiety and depression and somatization. These conditions may have an interactive effect upon each other, with symptoms of depression being exacerbated by somatoform syndromes and, conversely, somatic syndromes inducing depression, which can lead to a vicious cycle. Some have suggested that the manifestation of somatic symptoms is a kind of masked depression. In some individuals, the onset of somatic symptoms occurs just after loss or a stressful life event, which may be a stress reaction that is a physical, rather than emotional response; studies have found correlations between the suppression of emotions and higher rates of somatic symptoms. Somatization has also been explained as a type of phobia or an expression of anger or hostility. For some patients, the underlying reason for the somatic symptoms may be explained by a desire for economic gain through the collection of health benefits or disability insurance. Also, the attention received fulfills a need in some patients. Along with the wide variety of possible causes of this type of disorder, there are as many methods of treatment, and certain treatments may be more suitable for some patients than for others. Some patients with this condition experience spontaneous relief of symptoms; for others, psychotropic drugs may be helpful. (Consumer Summary produced by Reliance Medical Information, Inc.)

Somatoform disorders, Hypochondria, Hypochondriasis

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Psychological functioning in a cohort of gay men at risk for AIDS: a three-year descriptive study

Article Abstract:

This study explores mental health consequences of the AIDS epidemic in a cohort of 961 gay males at risk for, but not yet diagnosed with AIDS. Subjects were participants in the Chicago Multicenter AIDS Cohort Study (MACS) - an ongoing study investigating HIV natural history, which uses biannual physical examinations and laboratory studies. Chicago MACS subjects also participated in a concurrent behavioral and psychosocial study. At first visit, average age of subjects was 34.4 years, and average income was $25,537. Ninety percent of subjects were Caucasian. Data from six consecutive biannual questionnaires administered between 1984-1987 were assessed. General mental health was determined by the Hopkins Symptom Checklist (HSCL). Depression was measured with a shortened version of the Center for Epidemiologic Study Depression Scale (CESD-5) and one adapted Diagnostic Interview Schedule (DIS) question. Suicidal leanings were assessed by one question on the HSCL, and AIDS-specific distress was measured by three subscales developed for this study. Subjects' average symptom scores were higher than those found in the general population, but were considerably lower than scores of psychiatric outpatients. Self-reported episodes of depression lasting two weeks or more were experienced by 40.1 percent of the sample, while suicidal thoughts were reported on three or more visits by 18.8 percent of subjects. Younger subjects exhibited greater general and AIDS-specific distress. Subjects with higher incomes demonstrated less general distress than subjects with lower incomes. When compared with subjects who tested negative for HIV, those who tested positive demonstrated higher AIDS-specific distress scores, but had similar general distress and depression scores. Overall, AIDS-specific distress reactions increased consistently over the three-year span of the study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Stress (Psychology), Gay men, AIDS (Disease)

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