Assessment and Management of Somatoform and Conversion Symptoms

  • Mark S. Warner
  • M. Lucy Freeman
  • Lonn Guidry

Somatoform and conversion symptoms are common elements of inpatient and outpatient medical practice. Somatization has been called “one of medicine’s blind spots,”1 where the assumptions of Cartesian dualism can discourage the gathering of useful ideographic information and negatively impact efforts at successful treatment. From our perspective, the presence of somatoform and conversion factors demonstrates the need for continuous refinement of individualized assessment and treatment practices tailored to fit the constraints of clinical, operational, and financial parameters inherent in clinical settings. The pragmatic value of variety in clinical presentations is that it remind us that the focus of medical treatment is fundamentally to alleviate disease and suffering in the patient. To meet this responsibility, we are continually confronted with two dilemmas. First, the more we learn about the human being, the more we are confronted by the futility of Cartesian dualism in assuming that physical and mental factors are independent rather than interdependent. Second, the heterogeneity of human experience and response to illness reminds us that the science of medicine (or any other applied discipline for that matter) may be precise but successful application is often an art based on the accommodation of information and experience.


Timolol Maleate Internal Medicine Clinic Somatization Disorder Moderate Deficit Cartesian Dualism 
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  1. 1.
    Quill TE. Somatization disorder: one of medicine’s blind spots. JAMA. 1985;254:3075–3079.PubMedCrossRefGoogle Scholar
  2. 2.
    Abbey SE, Lipowski ZJ. Comprehensive management of persistent somatization: an innovative inpatient program. Psychother Psychosom. 1987;48:110–115.PubMedCrossRefGoogle Scholar
  3. 3.
    Ford CV. The Somatizing Disorders: Illness as a Way of Life. New York: Elsevier; 1983.Google Scholar
  4. 4.
    Mai F. Somatization disorder: a practical review. Can J Psychiatry. 2004;49:652–662.PubMedGoogle Scholar
  5. 5.
    Smith GR. The epidemiology and treatment of depression when it coexists with somatoform disorders, somatization, or pain. Gen Hosp Psychiatry. 1992;14:265–272.PubMedCrossRefGoogle Scholar
  6. 6.
    Abbey SE. Somatization and somatoform disorders. In: Rundell JR, Wise MG, eds. Textbook of Consultation-Liaison Psychiatry. Washington, DC: American Psychiatric Press; 1996:368–410.Google Scholar
  7. 7.
    Craig TK, Boardman AP, Mills K, Daly-Jones O, Drake H. The South London somatization study, I: longitudinal course and the influence of early life experiences. Br J Psychiatry. 1993;163:579–588.PubMedCrossRefGoogle Scholar
  8. 8.
    Ford CV. Somatizing disorders. In: Roback HB, ed. Helping Patients and Their Families Cope with Medical Problems. Washington, DC: Jossey-Bass; 1984:39–59.Google Scholar
  9. 9.
    Hahn SR, Thompson KS, Wills TA, Stern V, Budner NS. The difficult doctor-patient relationship: somatization, personality, and psychopathology. J Clin Epidemiol. 1994;47:647–657.PubMedCrossRefGoogle Scholar
  10. 10.
    Peek CJ. Bringing other cultures together: harmonizing the clinical, operational, and financial perspectives of health care. In: Patterson J, Peek CJ, Heinrich RL, Bishoff RJ, Scherger J, eds. Mental Health Professionals in Medical Settings: A Primer. New York: Norton; 2002.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Mark S. Warner
    • 1
  • M. Lucy Freeman
    • 1
  • Lonn Guidry
    • 1
  1. 1.Louisiana State University Health Sciences CenterUniversity Medical CenterLafayetteUSA

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