Differential Diagnosis of Somatization Disorder and Undifferentiated Somatoform Disorder

To manage these conditions successfully, it is important to differentiate them from other similar conditions. The most common disorders that need to be differentiated from somatization disorder and undifferentiated somatoform disorder are somatized anxiety, somatized depressive disorders, panic disorder, hypochondriasis, conversion disorder, chronic pain disorders, factitious disorder, and general medical problems.

Somatized Anxiety

Somatized anxiety is a condition that results when psychic anxiety is transformed into muscle tension. The important aspect of this differential diagnosis is that patients with somatized anxiety usually do not have a lifetime history of multiple unexplained somatic symptoms. Instead, they have one or two symptoms that could have begun at any age. Another differential factor is that somatized anxiety usually takes the form of musculoskeletal, sympathetic cardiovascular, or gastrointestinal symptoms. Although patients with somatization disorder and undifferentiated somatoform disorder do have comorbid anxiety, the larger picture is one of multiple unexplained somatic complaints along with the associated anxiety, rather than one of primarily anxiety with a few associated somatic symptoms.

Somatized Depressive Disorders

Patients with major depression or dysthymia may present with somatized symptoms, such as diffuse mild abdominal pain or shoulder or neck aches. However, patients with somatized depression do not have lifelong histories of multiple unexplained somatic complaints. Several somatic complaints may accompany their depression, but their history is primarily one of single or multiple episodes of depression with associated somatic symptoms, rather than one of multiple somatic symptoms with associated dysphoria or blue mood.