Abstract
The blurred boundaries between illnesses presenting with somatic symptoms confronts both psychiatrists and primary care physicians with one of the most challenging issues in patient care. On a typical day in a general physician’s office, perhaps 50 % or more of the patients with physical complaints will have no definitive explanation for their ailment (Simon et al. 1996; Kroenke and Mangelsdorff 1989; Kroenke 2003; Baumeister and Harter 2007; Smith and Dwamena 2007). The patients present with distress from fatigue, chest pain, cough, back pain, shortness of breath, and a host of other painful or worrisome bodily concerns. For most, the physician’s expression of interest, taking a thorough history, doing a physical examination, and offering reassurance, a modest intervention, or a pharmacologic prescription suffices to assuage the patient’s pain, anxiety, and physical distress. But for some, these simple measures fall short of their expected result, marking the beginning of what may become a chronic search for relief, including frequent anxiety-filled visits to more than one physician, and in extreme cases even multiple hospitalizations and possibly surgery.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Allen, L. A., Woolfolk, R. L., Escobar, J. I., Gara, M. A., & Hamr, R. M. I. (2006). Cognitive behavioral therapy for somatization disorder: A randomized controlled trial. Archives of Internal Medicine, 166, 1512–1518.
Allen, L. A., Escobar, J. I., Lehrer, P. M., Gara, M. A., & Woolfork, R. L. (2002). Psychosocial treatments for multiple unexplained physical symptoms: A review of the literature. Psychosomatic Medicine, 64, 939–950.
American Psychiatric Association. (1950). Diagnostic and statistical manual of mental disorders (DSM-I) (1st ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorders (DSM-II) (2nd ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (DSM-III) (3rd ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: American Psychiatric Association.
Avia, M. D., & Ruiz, M. A. (2005). Recommendations for the treatment of hypochondriac patients. Journal of Contemporary Psychotherapy, 35, 301–313.
Barsky, A. J., & Ahern, D. K. (2004). Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. Journal of American Medical Association, 291, 1464–1470.
Barsky, A. J., Cleary, P. D., Wyshak, G., Spitzer, R. L., Williams, J. B. W., & Klerman, G. L. (1992). A structured diagnostic interview for hypochondriasis: A proposed criterion standard. The Journal of Nervous and Mental Disease, 180, 20–27.
Barsky, A. J., Wyshak, G., & Klerman, G. L. (1990). The somatosensory amplification scale and its relationship to hypochondriasis. Journal of Psychosomatic Research, 24, 323–334.
Bass, C. (1990). Somatization: Physical symptoms and psychological illness. Oxford: Blackwell.
Bass, C., & Benjamin, S. (1993). The management of chronic somatisation. The British Journal of Psychiatry, 162, 472–480.
Baumeister, H., & Harter, M. (2007). Prevalence of mental disorders based on general population surveys. Social Psychiatry and Psychiatric Epidemiology, 42, 537–546.
Brondino, N., Lnati, N., Barale, F., Martinelli, V., Politi, P., & Geroldi, D. (2008). Decreased NT-3 plasma levels and platelet serotonin content in patients wit hypochondriasis. Journal of Psychosomatic Research, 65, 435–439.
Burton, R. (1621). The anatomy of melancholy. London: Thomas Tegg. Reprinted by Gryphon Editions, 1988.
Cochrane Summary. Consultation letters for use by primary care physicians in their care of patients with physical symptoms for which no organic cause can be found. Retrieved 8 Dec 2010, from http:/summaries.cochrane.org/CD006524
Cochrane Summary. Enhanced care by generalists for functional somatic symptoms and disorders in primary care. Retrieved 7 Oct 2009a, from http:/summaries.cochrne.org/CD008142
Cochrane Summary. Improving outcomes for people with multiple chronic conditions. Retrieved 18 Apr 2012, from http:/summaries.cochrane.org/CD006560
Cochrane Summary. Psychosocial interventions delivered by GPs. Retrieved 15 Apr 2009b, from http:/summaries.cochrane.org/CD003494. April 15, 2009b.
Cochrane Summary. Psychotherapies for hypochondriasis (review). Retrieved 30 July 2007, from http:/summaries.cochrane.org/CD006520
Creed, F. (2006). Should general psychiatry ignore somatisation and hypochondriasis? World Psychiatry, 5, 146–150.
Creed, F., Guthrie, E., Fink, P., Henningsen, P., Rief, W., Sharpe, M., et al. (2010). Is there a better term than “medically unexplained symptoms”? Journal of Psychosomatic Research, 68, 5–8.
Dimsdale, J., Patel, V., Xin, Y., & Kleinman, A. (2007). Somatic presentations—A challenge for DSM-V. Psychosomatic Medicine, 69, 829 [Editorial].
Dimsdale, J., & Creed, F. (2009). The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV—A preliminary report. Journal of Psychosomatic Research, 66, 473–476.
Escobar, J. I., Gara, M. A., Diaz-Martinez, A. M., Interian, A., Warman, M., Allen, L. A., et al. (2007). Effectiveness of a time-limited cognitive behavior therapy type intervention among primary care patients with medically unexplained symptoms. Annals of Family Medicine, 5, 328–335.
Escobar, J. I., Rubio-Stipec, M., Canino, G., & Karno, M. (1989). Somatic symptom index (SSI): A new and abridged somatization construct. Prevalence and epidemiological correlates in two large community samples. The Journal of Nervous and Mental Disease, 177, 140–146.
Fallon, B. A. (2001). Pharmacologic strategies for hypochondriasis. In V. Starcevic & D. R. Lipsitt (Eds.), Hypochondriasis: New perspectives on an ancient Malady (pp. 329–351). New York, NY: Oxford University Press.
Fallon, B. A., Petkova, E., Skritskaya, N., Sanchez-Lacey, A., Schneier, F., Vermes, D., et al. (2008). A double-masked, placebo-controlled study of fluoxetine for hypochondriasis. Journal of Clinical Psychopharmacology, 2, 638–645.
Fink, P., Ombol, E., Toft, T., Sparle, K. C., Frostholm, L., & Olesen, F. (2004). A new empirically established hypochondriasis diagnosis. The American Journal of Psychiatry, 161, 1680–1691.
Frances, A., First, M. B., & Pincus, H. A. (1995). DSM-IV guidebook. Washington, DC: American Psychiatric Press.
Freud, S. (1986). Fragment of an analysis of a case of hysteria (1905). In J. Strachey (Ed.), The standard edition of the complete works of Sigmund Freud (Vol. 7, pp. 7–63). London: Hogarth Press.
Garcia-Campayoa, J., Fayed, N., Serrano-Blanco, A., & Roca, M. (2009). Brain dysfunction behind functional symptoms: Neuroimaging and somatoform, conversive, and dissociative disorders. Current Opinion in Psychiatry, 22, 224–231.
Goldberg, D., Gask, L., & O’Dowd, T. (1989). Treatment of somatization: Teaching techniques of reattribution. Journal of Psychosomatic Research, 33, 689–695.
Greeven, A., van Balkom, A. J., Visser, S., Merkelbach, J. W., van Rood, Y. R., van Dyck, R., et al. (2007). Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: A randomized controlled trial. The American Journal of Psychiatry, 164, 91–99.
Gureje, O., Utsun, T. B., & Simon, G. E. (1997). The syndrome of hypochondriasis: A cross-national study in primary care. Psychological Medicine, 27, 1001–1010.
Guze, S. B. (1983). Genetics of Briquet’s syndrome and somatization disorder: A review of family, adoption, and twin studies. Annals of Clinical Psychiatry, 5, 225–230.
Hahn, S. (2001). Physical symptoms and physician-experienced difficulty in the physician-patient relationship. Annals of Internal Medicine, 134, 897–904.
Hatcher, S., & Arroll, B. (2008). Assessment and management of medically unexplained symptoms. British Medical Journal, 336, 1124–1128.
Henningsen, P., Zipfel, S., & Herzog, W. (2007). Management of functional somatic syndromes. Lancet, 369, 946–955.
Kashner, T. M., Rost, K., Cohen, B., Anderson, M., & Smith, G. R., Jr. (1995). Enhancing the health of somatization disorder patients. Effectiveness of short-term group therapy. Psychosomatics, 36, 462–470.
Katon, W., Kleinman, A., & Rosen, G. (1984). The prevalence of somatization in primary care. Comprehensive Psychiatry, 25, 127–135.
Katon, W., von Korff, M., Lin, E., Simon, G., Walker, E., Unutzer, J., et al. (1999). Stepped collaborative care for primary care patients with persistent symptoms of depression: A randomized trial. Archives of General Psychiatry, 56, 1109–1115.
Kellner, R. (1991). Psychosomatic syndromes and somatic symptoms. Washington, DC: American Psychiatric Press.
Kellner, R., Abbott, P., Pathak, D., Winslow, W. W., & Umland, B. E. (1983–1984). Hypochondriacal beliefs and attitudes in family practice and psychiatric patients. International Journal of Psychiatry in Medicine, 13, 127–139.
Kent, C., & McMillan, G. (2009). A CBT-based approach to medically unexplained symptoms. Advances in Psychiatric Treatment, 15, 146–151.
Kirmayer, L. J., & Young, A. (1998). Culture and somatization: Clinical, epidemiological, and ethnographic perspectives. Psychosomatic Medicine, 60, 420–430.
Kravitz, R. L. (2001). Measuring patients’ expectations and requests. Annals of Internal Medicine, 134, 881–888.
Kroenke, K. (2007). Efficacy of treatment for somatoform disorders: A review of randomized controlled trials. Psychosomatic Medicine, 69, 881–888.
Kroenke, K. (2003). Patients presenting with somatic complaints: Epidemiology, psychiatric comorbidity and management. International Journal of Methods in Psychiatric Research, 12, 34–43.
Kroenke, K. (2006). Physical symptom disorder. A simpler diagnostic category for somatisation-spectrum conditions. Journal of Psychosomatic Research, 60, 335–339.
Kroenke, K., & Mangelsdorff, D. (1989). Common symptoms in ambulatory care: Incidence, evaluation, therapy and outcome. The American Journal of Medicine, 86, 262–266.
Kroenke, K., Messina, N., III, Benattia, I., Graepel, J., & Musgnung, J. (2006). Venlafaxine extended release in the sort-term treatment of depressed and anxious primary care patients with multisomatoform disorder. Clinical Psychiatry, 67, 72–80.
Kroenke, K., Sharpe, M., & Sykes, R. (2007). Revising the classification of somatoform disorders. Key questions and preliminary recommendations. Psychosomatics, 48, 277–285.
Kroenke, K., & Swindle, R. (2000). Cognitive-behavioral therapy for somatization and symptom syndromes: A critical review of controlled clinical trials. Psychotherapy and Psychosomatics, 69, 205–215.
Lidbeck, J. (2003). Group therapy for somatization disorders in primary care: Maintenance of treatment goals of short cognitive-behavioural treatment one-and-one-half-year follow-up. Acta Psychiatrica Scandinavica, 107, 449–456.
Lipowski, Z. J. (1988). Somatization: The concept and its clinical application. The American Journal of Psychiatry, 145, 1358–1368.
Lipsitt, D. R. (1970). Medical and psychological characteristics of “crocks”. Psychiatric Medicine, 1, 15–25.
Lipsitt, D. R. (1987). The difficult doctor-patient relationship. In W. T. Branch Jr. (Ed.), Office practice of medicine (2nd ed., pp. 1348–1356). Philadelphia, PA: WB Saunders.
Lipsitt, D. R. (1992). Challenges of somatization: Diagnostic, therapeutic and economic. Psychiatric Medicine, 10, 1–12.
Lipsitt, D. R. (1996). Primary care of the somatizing patient: A collaborative model. Hospital Practice, 31, 77–88.
Lipsitt, D. R. (1998). Commerce between the mind and the body. Advances in Mind-Body Medicine, 14, 107–113.
Lipsitt, D. R. (2001a). Psychodynamic perspectives on hypochondriasis. In V. Starcevic & D. R. Lipsitt (Eds.), Hypochondriasis: Modern perspectives on an ancient Malady (pp. 265–290). New York, NY: Oxford University Press.
Lipsitt, D. R. (2001b). The physician-patient relationship in the treatment of hypochondriasis. In V. Starcevic & D. R. Lipsitt (Eds.), Hypochondriasis: Modern perspectives on an ancient Malady (pp. 183–201). New York, NY: Oxford University Press.
Lipsitt, D. R. (2002). Psychotherapy. In M. G. Wise & J. R. Rundell (Eds.), Textbook of consultation-liaison psychiatry (2nd ed., pp. 1027–1051). Washington, DC: American Psychiatric Press.
Lipsitt, D. R. (2009). Results of a focus group. Workshop presentation, 162nd annual meeting. San Francisco, CA: American Psychiatric Association.
Lipsitt, D. R., & Starcevic, V. (2006). Psychotherapy and pharmacotherapy in the treatment of somatoform disorders. Psychiatric Annals, 36, 341–346.
Lynch, D. J., McGrady, A., Nagel, R., & Zsembik, C. (1999). Somatization in family practice: comparing 5 methods of classification. (Primary Care Companion to) The Journal of Clinical Psychiatry, 1, 85–89.
Marin, C., & Carron, R. (2002). The origin of the concept of somatization [letter]. Psychosomatics, 43, 249–250.
Margo, K. L., & Margo, G. M. (2000). Early diagnosis and empathy in managing somatization. American Family Physician, 61, 1282–1285.
Martin, R. L. (1999). The somatoform conundrum: A question of nosological values. General Hospital Psychiatry, 19, 177–186.
Mayou, R., Kirmayer, L. J., Simon, G., Kroenke, K., & Sharpe, M. (2005). Somatoform disorders: Time for a new approach in DSM-V. The American Journal of Psychiatry, 162, 847–855.
McCahill, M. (1999). Labeling the somatically preoccupied. Have we gone too far? American Family Physician, 59, 2980 [editorial].
McLeod, C. C., Budd, M. A., & McClelland, D. C. (1997). Treatment of somatization in primary care. General Hospital Psychiatry, 19, 251–258.
Menza, M., Lauritano, M., Allen, L., Warman, M., Ostella, F., Hamer, R. M., et al. (2001). Treatment of somatization disorder with nefazodone: A prospective, open-label study. Annals of Clinical Psychiatry, 13, 153–158.
olde Hartman, T. C., Borghuis, M. S., Lucassen, P. L., van de Laar, F. A., Speckens, A. E., & van Weel, C. (2009a). Medically unexplained symptoms in somatization disorder and hypochondriasis: Course and prognosis. A systematic review. Journal of Psychosomatic Research, 66, 363–377.
olde Hartman, T. C., Hassink-Franke, L. J., Lucassen, P. L., van Spaendonck, K. P., & van Weel, C. (2009b). Explanation and relations: How do general practitioners deal with patients with persistent medically unexplained symptoms: A focus group study. BMC Family Practice, 10, 68.
Okugawa, G., Yagi, A., Kusaka, H., & Kinoshita, T. (2002). Paroxetine for treatment of somatization disorder. The Journal of Neuropsychiatry and Clinical Neurosciences, 14, 464–465.
Othmer, E., & DeSouza, C. (1985). A screening test for somatization disorder (hysteria). The American Journal of Psychiatry, 142, 1146–1149.
Pedrosa, G. F., Scheidt, C. E., Hoeger, D., & Nickel, M. (2008). Relationship between attachment style, parental bonding and alexithymia in adults with somatoform disorders. International Journal of Psychiatry in Medicine, 38, 437–451.
Perley, M. J., & Guze, S. B. (1962). Hysteria—The stability and usefulness of clinical criteria. A quantitative study based on a follow-up period of six to eight years in 39 patients. The New England Journal of Medicine, 266, 421–426.
Pilowsky, I. (1967). Dimensions of hypochondriasis. The British Journal of Psychiatry, 113, 89–93.
Pilowsky, I. (1969). Abnormal illness behavior. The British Journal of Medical Psychology, 42, 347–351.
Pilowsky, I., Spence, N., Cobb, J., & Katsikitis, M. (1984). The illness behavior questionnaire as an aid to clinical assessment. General Hospital Psychiatry, 6, 123–130.
Rosendal, M., Olesen, F., & Fink, P. (2005). Management of medically unexplained symptoms. British Medical Journal, 33, 4–5.
Rost, K., Kashner, T. M., & Smith, G. R. (1994). Effectiveness of psychiatric intervention with somatization disorder patients: Improved outcomes at reduced costs. General Hospital Psychiatry, 16, 381–387.
Salmon, P., Dowrick, C. F., Ring, A., & Humphris, G. M. (2004). Voiced but unheard agendas: Qualitative analysis of the psychosocial cues that patients with unexplained symptoms present to general practitioners. The British Journal of General Practice, 54, 171–176.
Salmon, P., Peters, S., Clifford, R., Iredale, W., Gask, L., Rogers, A., et al. (2007). Why do general practitioners decline training to improve management of medically unexplained symptoms? Journal of General Internal Medicine, 22, 565–571.
Schaefert, R., Kaufman, C., Wild, B., Schelberg, D., Boelter, R., Faber, R., et al. (2013). Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: A cluster randomized controlled trial. Psychotherapy and Psychosomatics, 82, 106–119.
Schur, M. (1955). Comments on the metapsychology of somatization. Psychoanalytic Study of the Child, 10, 119–164.
Schweitzer, P. J., Zafar, U., Pavlicova, M., & Fallon, B. A. (2011). Long-term follow-up of hypochondriasis after selective serotonin reuptake inhibitor treatment. Journal of Clinical Psychopharmacology, 31, 365–368.
Servan-Schreiber, D., Kolb, N. R., & Tabas, G. (2000a). Somatizing patients: Part I. Practical diagnosis. American Family Physician, 61, 1073–1078.
Servan-Schreiber, D., Tabas, G., & Kolb, R. (2000b). Somatizing patients: Part II. Practical management. American Family Physician, 61, 1423–1428.
Sharpe, M., & Carson, A. (2001). “Unexplained” somatic symptoms, functional syndromes, and somatization: Do we need a paradigm shift? Annals of Internal Medicine, 134, 926–930.
Shorter, E. (1992). From paralysis to fatigue: A history of psychosomatic illness in the modern era. New York, NY: Free Press.
Simon, G., Gater, R., Kisly, S., & Piccinelli, M. (1996). Somatic symptoms of distress: An international primary care study. Psychosomatic Medicine, 58, 481–488.
Simon, G. E. (2002). Treatment of somatoform and factitious disorders. In P. E. Nathan & J. M. Gorman (Eds.), A guide to treatments that work (pp. 408–422). New York, NY: Oxford University Press.
Smith, G. R., Jr. (1995). Somatization disorder and undifferentiated somatoform disorder. In G. O. Gabbard (Ed.), Treatments of psychiatric disorders, vol 2 (2nd ed., pp. 1716–1733). Washington, DC: American Psychiatric Press.
Smith, G. R., Jr., Monson, R. A., & Kay, D. C. (1986). Psychiatric consultation in somatization disorder: A randomized controlled study. The New England Journal of Medicine, 314, 1407–1413.
Smith, R. C., & Dwamena, F. C. (2007). Classification and diagnosis of patients with medically unexplained symptoms. Journal of General Internal Medicine, 22, 685–691.
Smith, R. C., Gardiner, J. C., Luo, Z., Schooley, S., Lamerato, S., & Rost, K. (2009). Primary care physicians treat somatization. Journal of General Internal Medicine, 24, 829–832.
Smith RC, Dwamena FC. (2012). Primary care management of medically unexplained symptoms. UpToDate. www.uptodate.com
Smith, R. C., Gardiner, J. C., Lyles, J. S., Sirbu, C., Dwamena, F. C., Hodges, A., et al. (2005). Exploration of DSM-IV criteria in primary care patients with medically unexplained symptoms. Psychosomatic Medicine, 67, 123–129.
Smith, R. C., Lyles, J. S., Gardiner, J. C., Sirbu, C., Hodges, A., Collins, C., et al. (2006). Primary care clinicians treat patients with medically unexplained symptoms: A randomized controlled trial. Journal of General Internal Medicine, 21, 671–677.
Speckens, A. E. M. (2001). Assessment of hypochondriasis. In V. Starcevic & D. R. Lipsitt (Eds.), Hypochondriasis: Modern perspectives on an ancient Malady (pp. 61–88). New York, NY: Oxford University Press.
Stahl, S. M. (2003). Antidepressants and somatic symptoms: Therapeutic actions are expanding beyond affective spectrum disorders to functional somatic syndromes. Journal of Clinical Psychiatry, 65, 745–746.
Starcevic, V. (2001). Reassurance in the treatment of hypochondriasis. In V. Starcevic & D. R. Lipsitt (Eds.), Hypochondriasis: New perspectives on an ancient Malady (pp. 291–313). New York, NY: Oxford University Press.
Stein, D. J., & Muller, J. (2008). Cognitive-affective neuroscience of somatization disorder and functional somatic syndromes: Reconceptualizing the triad of depression-anxiety-somatic symptoms. CNS Spectrums, 13, 379–384.
Stekel, W. (1943). The interpretation of dreams. New York, NY: Liveright.
Stuart, S., & Noyes, R., Jr. (2006). Interpersonal psychotherapy for somatizing patients. Psychotherapy and Psychosomatics, 75, 209–219.
Sumathipala, A. (2007). What is the evidence for the efficacy of treatments for somatoform disorders? A critical review of previous intervention studies. Psychosomatic Medicine, 69, 889–900.
Swartz, M., Landerman, R., George, L., Blazer, D., & Escobar, J. (1990). Somatization disorder. In L. N. Robins & D. Regier (Eds.), Psychiatric disorders in America: The epidemiologic catchment area study (pp. 220–257). New York, NY: Free Press.
Swartz, M. S., Hughes, D., George, L., Blazer, D., Landerman, R., & Bucholz, K. (1986). Developing a screening index for community studies of somatization disorder. Journal of Psychiatric Research, 20, 335–343.
Sykes, R. (2012). Somatoform disorder and the DSM-V Workgroup’s interim proposals: Two central issues. Psychosomatics, 53, 334–338.
Takii, M., Muranaga, T., & Nozoe, S. (1994). A study of the clinical features of unidentified clinical syndrome (so-called vegetative syndrome). Shin-shin Igaku, 34, 573–580 (English summary).
Taylor, R. E., Marshall, T., Mann, A., & Goldberg, D. P. (2012). Insecure attachment and frequent attendance in primary care: A longitudinal cohort study of medically unexplained symptom presentations in ten UK general practices. Psychological Medicine, 42, 855–864.
Tyrer, P., Fowler-Dixon, R., Ferguson, B., & Keleman, A. (1990). A plea for the diagnosis of hypochondriacal personality disorder. Journal of Psychosomatic Research, 34, 637–642.
van den Heuvel, O. A., Mataix-Cols, D., Zwitser, G., Cath, D. C., van der Werf, Y. D., Groenewegen, H. J., et al. (2011). Common limbic and frontal-striatal disturbances in patients with obsessive-compulsive disorder, panic disorder and hypochondriasis. Psychological Medicine, 41, 2399–2410.
Viswanathan, R., & Paradis, C. (1991). Treatment of cancer phobia with fluoxetine. The American Journal of Psychiatry, 148, 1090.
Voigt, K., Nagel, A., Meyer, B., Langs, G., Braukhaus, C., & Lowe, B. (2010). Towards positive diagnostic criteria: A systematic review of somatoform disorder diagnoses and suggestions for future classification. Journal of Psychosomatic Research, 68, 403–414.
Waller, B., Scheidt, C. E., & Hartmann, A. (2002). Attachment representation and illness behavior in somatoform disorders. The Journal of Nervous and Mental Disease, 192, 200–209.
Walters, K., Buszewicz, M., Welch, S., & King, M. (2008). Help-seeking preferences for psychological distress in primary care: Effect of current mental state. The British Journal of General Practice, 58, 694–698.
Warwick, H. M., Clark, D. M., Cobb, A. M., & Salkovskis, P. (1996). A controlled trial of cognitive-behavioural treatment of hypochondriasis. The British Journal of Psychiatry, 169, 189–195.
Wessely, S., Nimnuan, C., & Sharpe, M. (1999). Functional somatic syndromes: One or many? Lancet, 354, 936–939.
Wickramasekera, I. (1989). Somatizers, the health care system, and collapsing the psychological distance that the somatizer has to travel for help. Professional Psychology: Research and Practice, 20, 105–111.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Hoyle Leigh & Jon Streltzer
About this chapter
Cite this chapter
Lipsitt, D.R. (2015). Hypochondriasis and Somatization Disorder: New Perspectives. In: Leigh, H., Streltzer, J. (eds) Handbook of Consultation-Liaison Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-11005-9_23
Download citation
DOI: https://doi.org/10.1007/978-3-319-11005-9_23
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-11004-2
Online ISBN: 978-3-319-11005-9
eBook Packages: MedicineMedicine (R0)