Following General Management Techniques for Somatization Disorder

Appropriate treatment of somatization disorder can begin once the correct disorder has been diagnosed. However, because the etiology of this disorder is not known and no curative or ameliorative therapies have been found, a discussion of treatment necessarily focuses on management of symptoms. Although there have been few formal treatment or management studies, a broad consensus concerning appropriate management strategies exists among experienced clinicians.

Kashner et al. (1992), Rost et al. (1994), and G. R. Smith et al. (1986a) investigated cost-effective approaches to treating patients with somatization disorder in primary care settings. These researchers found that certain management strategies resulted in improvement or maintenance of a constant health status among patients with somatization disorder, decreased use of health care services, and increased patients' satisfaction with their care: 1) making the primary care physician the patient's primary and, if possible, only physician; 2) scheduling regular outpatient visits every 4-6 weeks; 3) making these frequent visits brief enough to fit into a busy primary care practice; and 4) conducting a partial physical examination of the organ system that is the object of the patient's complaints during each visit.

Primary care physicians also should consider that symptoms can communicate emotional needs as well as physical disease. If they look for signs of disease rather than focus on symptoms, they can often avoid unnecessary diagnostic tests, laboratory evaluations, and diagnostic or operative procedures. Another goal of primary care management, not tested in these studies, should be to prepare some patients for referral to the mental health sector for care.