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Stress and Somatic Symptoms pp 123–130Cite as

General Management of Somatization

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Abstract

Cognitive behavioral therapy (CBT) is known to be effective in patients with somatic symptom and related disorders. History taking, physical examination, and investigations can be used to confirm or refute the patients’ beliefs. Mindfulness-based cognitive therapy (MBCT) can help improve mental functioning (e.g., vitality and social functioning) in somatizing patients and change unhelpful behavioral patterns and increase self-care. In particular, MBCT can be considered a meaningful therapy for patients with somatizing disorders because it encourages them more willing to receive mental health care. Psychiatric consultation can be used as therapeutic strategy. In addition, psychopharmacotherapy is essential for management of somatization. Considering the limitations of time for physicians, an integrated brief therapy is recommended for such patients. This form of therapy should be multimodal by combining psychiatric consultation, CBT, and psychopharmacotherapy.

“Whenever I see difficult somatizing patients, I think their personal needs and their views on illness should be understood and respected. On one hand, management for these patients requires empathetic patience from therapists. On the other hand, love and care from their important person involved may be a panacea for their illness in some cases.”

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References

  1. Sharma MP, Manjula M. Behavioral and psychological management of somatic symptom disorders: an overview. Int Rev Psychiatry. 2013;25:116–24.

    Article  Google Scholar 

  2. Patel V, Sumathipala A. Psychological approaches to somatization in developing countries. Adv Psychiatry Treat. 2006;12:54–62.

    Article  Google Scholar 

  3. Sharpe M, Peveler R, Mayou R. The psychological treatment of patients with functional somatic symptoms: a practical guide. J Psychosom Res. 1992;36:515–29.

    Article  Google Scholar 

  4. Bass C, Benjamin S. The management of chronic somatization. Brit J Psychiatry. 1993;162:472–80.

    Article  Google Scholar 

  5. Bass C, Peveler R, House A. Somatoform disorder: severe psychiatric illnesses neglected by psychiatrists. Brit J Psychiatry. 2001;179:11–4.

    Article  Google Scholar 

  6. Fink P, Rosenthal M. Recent developments in the understanding and management of functional somatic symptoms in primary care. Curr Opin Psychiatry. 2008;21:182–8.

    Article  Google Scholar 

  7. Kroenke K. Patients presenting with somatic complaints: epidemiology, psychiatric comorbidity and management. Int J Methods Psychiatr Res. 2003;12:34–43.

    Article  Google Scholar 

  8. Kroenke K. Efficacy of treatment for somatoform disorders: a review of randomized controlled trials. Psychosom Med. 2007;69:881–8.

    Article  Google Scholar 

  9. Price JR. Managing physical symptoms: the clinical assessment as treatment. J Psychosom Res. 2000;48:1–10.

    Article  Google Scholar 

  10. Salkovskis PM. Somatic problems. In: Hawton K, Salkovskis PM, Kirk J, et al., editors. Cognitive behavior therapy for psychiatric problems. A practical guide. Oxford: Oxford University Press; 1989.

    Google Scholar 

  11. Thomas KB. General practice consultations: is there any point in being positive? BMJ. 1987;294:1200–2.

    Article  Google Scholar 

  12. Fitzpatrick RM, Hopkins A. Referrals to neurologists for headaches not due to structural disease. J Neurol Neurosurg Psychiatry. 1981;44:1061–7.

    Article  Google Scholar 

  13. van Dulmen A, Fennis JF, Mokkink HG, et al. Doctor-dependent changes in complaint-related cognitions and anxiety during medical consultations in functional abdominal complaints. Psychol Med. 1995;25:1011–8.

    Article  Google Scholar 

  14. Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clin Psychol Rev. 2011;31:1032–40.

    Article  Google Scholar 

  15. Manicavasgar V, Parker G, Perich T. Mindfulness-based cognitive therapy vs cognitive behavior therapy as a treatment for non-melancholic depression. J Affect Disord. 2011;130:138–44.

    Article  Google Scholar 

  16. Hofmann SG, Sawyer AT, Fang A. The empirical status of the new wave of cognitive behavioral therapy. Psychiatr Clin N Am. 2010;33:701–10.

    Article  Google Scholar 

  17. Felder JN, Dimidjian S, Segal Z. Collaboration in mindfulness-based cognitive therapy. J Clin Psychol. 2012;68:179–86.

    Article  Google Scholar 

  18. Lakhan SE, Schhofield KL. Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis. PLoS One. 2013;8:e71834.

    Article  Google Scholar 

  19. van Ravesteijn H, Lucassen P, Bor H, et al. Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: a randomized controlled trial. Psychother Psychosom. 2013;82:299–310.

    Article  Google Scholar 

  20. van Ravesteijn H, Suijkerbuijk YB, Langbroek JA, et al. Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: process of change. J Psychosom Res. 2014;77:27–33.

    Article  Google Scholar 

  21. van Ravesteijn H. Mindfulness-based cognitive therapy for patients with somatoform disorders. Tijdschr Psychiatry. 2016;58:198–206.

    Google Scholar 

  22. Smith GR Jr. Effectiveness of treatment for somatoform disorder patients. Psychiatry Med. 1991;9:545–58.

    Google Scholar 

  23. van der Feltz-Cornelis CM, van Oppen P, Ader HJ, et al. Randomized controlled trial of a collaborative care model with psychiatric consultation for persistent medically unexplained symptoms in general practice. Psychother Psychosom. 2006;75:282–9.

    Article  Google Scholar 

  24. Strain JJ. Consultation-liaison psychiatry. In: Sadock BJ, Sadock VA, editors. Comprehensive textbook of psychiatry. 7th ed. Baltimore: Lippincott Williams & Wilkins; 2000.

    Google Scholar 

  25. Somashekar B, Jainer A, Wuntakal B. Psychopharmacotherapy of somatic symptoms disorders. Int Rev Psychiatry. 2013;25:107–15.

    Article  Google Scholar 

  26. Linch ME. Antidepressants as analgesics: a review of randomized controlled trials. J Psychiatry Neurosci. 2001;26:30–6.

    Google Scholar 

  27. Sussman N. SNRIs versus SSRIs: mechanisms of action in treating depressions and painful physical symptoms. Primary Care Companion J Clin Psychiatry. 2003;5:19–26.

    Article  Google Scholar 

  28. Fishbain DA, Cutler RB, Rosomoff HL. Do antidepressants have an analgesic effect in psychogenic pain and somatoform pain disorder? A meta-analysis. Psychosom Med. 1998;60:503–9.

    Article  Google Scholar 

  29. Noyes R Jr, Holt CS, Kathol RG. Somatization: diagnosis and management. Arch Fam Med. 1995;4:790–5.

    Article  Google Scholar 

  30. Morriss R, Gask L, Ronalds C, et al. Clinical and patient satisfaction outcomes of a new treatment for somatized mental disorder taught to general practitioners. Br J Gen Pract. 1999;49:262–7.

    Google Scholar 

  31. Morriss RK, Gask L. Treatment of patients with somatized mental disorder: effects of reattribution training on outcomes under the direct control of the family doctor. Psychosomatics. 2002;43:394–9.

    Article  Google Scholar 

  32. Gask L, Goldberg D, Porter R, et al. The treatment of somatization: evaluation of a teaching package with general practice trainees. J Psychosom Res. 1989;33:697–703.

    Article  Google Scholar 

  33. Rosendal M, Olesen F, Fink P, et al. A randomized controlled trial of brief training in the assessment and treatment of somatization in primary care: effects on patient outcome. Gen Hosp Psychiatry. 2007;29:364–73.

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea

    Kyung Bong Koh

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  1. Kyung Bong Koh
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Koh, K.B. (2018). General Management of Somatization. In: Stress and Somatic Symptoms. Springer, Cham. https://doi.org/10.1007/978-3-030-02783-4_12

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