Consideration of Psychosocial Factors

Disability

Most people find that their work provides structure for their lives, income for sustaining their families, and incentives for maintaining their health, although many disability plans discourage the latter. Work disability among patients with somatization disorder, who are often incapacitated by their symptoms and have limited capacities for dealing with their world, is problematic. For patients with somatization disorder, reported rates of disability range from 26% to 86%. The enormous societal costs paid on behalf of disabled workers make work disability a major complication of this disorder.

Because work also adds meaning and structure to the lives of patients with somatization disorder, they should clearly and constantly be encouraged to continue to work. One option may be to help the patient find less distressing employment with the assistance of vocational counselors or rehabilitative services. However, my usual practice is to help patients obtain some form of disability payment after they have made numerous efforts to maintain employment.