Somatisation

Question 1

What is the definition of somatisation?

Answer 1

Bodily symptoms with no sufficient cause for them, presumed psychological causation

Question 2

How common is somatisation?

Answer 2

0.2% lifetime prevalence

Question 3

What is the pathology of somatisation?

Answer 3

• Includes:
• Somatic symptom disorder
• Illness anxiety disorder and many more…
• Stress → release of cortisol = can lead to physical symptoms

Question 4

What are the risk factors/aetiology of somatisation?

Answer 4

• Before the age of 40
• Major depressive disorder
• Major anxiety disorder
• Childhood illness
• History of parental anxiety when patient was a child
• First degree relative
• Childhood sexual abuse

Question 5

What are the signs/symptoms of somatisation?

Answer 5

• Long, complex medical histories
• Mainly non specific general symptoms
• Discrepancies in subjective and objective findings
• Either many systems affected or one system affected until no cause can be found and then another system is affected
• Patients life revolves around their illness
• Excessive use of medical services and alternative therapies

Question 6

What investigation are conducted for suspected somatisation?

Answer 6

• Observe patient in waiting room for inconsistency in symptoms
• Obtain full hospital and GP notes
• History: full details of current symptoms, illness beliefs, past medical history
• Mental state examination

Question 7

What are the non pharmacological treatments for somatisation?

Answer 7

• Reassure
• Physiotherapy
• Psychotherapy
• Pain management clinic
• Stop or ↓ unnecessary drugs
• Educate patient/family
• Plan appointment frequently
• CBT
• Group therapy