Somatization and Somatic Symptom Disorder Mnemonics (Memorable Psychiatry Lecture)

Some people have a tendency to experience psychological stress in the form of physical symptoms like chest discomfort, stomach aches, or focal pain, a phenomenon known as somatization. This can make diagnosis tricky for clinicians, as the presenting symptoms are not reflective of the underlying pathology. Patients with severe and persistent somatization are sometimes diagnosed with somatoform disorders. In this video, we will look at the process of somatization more generally and then talk about somatic symptom disorder, a condition that features somatization as its primary symptom.

Learn more somatization and somatic symptom disorder, including its core signs and symptoms, prognosis, and treatment, in this high-yield talk intended for all healthcare providers, including doctors, medical students, psychologists, nurses, nurse practitioners, physician assistants, social workers, and more!

ATTRIBUTIONS
Licensed under Creative Commons: By Attribution 3.0 License

[alicesmith]

I had begun to experience severe joint pain, a rash that was only getting worse, and pain like I'd never experienced on a regular basis. Over a year and a few months, I had seen 5-6 different doctors because of my situation. It finally took an ER doctor to tell me he thought it was Lupus, treated me with meds that treat the symptoms I was having. It would be a new primary doctor who tested me, confirmed my diagnoses. The time between my first known symptoms and my actual diagnosis had caused even more issues. I was suffering with anxiety, depression and fear of the "unknown". Having been seen by so many doctors, telling them my symptoms, examining my rash, and it took an ER doctor to put it together. I was relieved because I had a name finally for my symptoms. I was asked by a doctor, if I was doctor shopping for meds. Not only that, but I had not got a single pain med from any of the doctors I'd seen. He was the last doctor I saw before having to go to the ER with a high grade fever, which eventually lead to my diagnosis.

[darcichambers]

My neurologist telling me a year after brain surgery for arachnoid cyct, that I was making up my debilitating headaches made me not see another neurologist or neurosurgeon for 15 years. I did start looking obsessively for answers. Luckily for me I found a support group for arachnoid cycst suffers. Symptoms after surgery are rare but real for us, but since cysts are so easy to treat, no follow-up care is usually done past the normal post op. Thus I never meet this criteria. I did talk with my therapist about it as one of my concerns and triggers for my bi-polar 1. But they never came to the conclusion that this is just a trick of my mind. But it still took me a very long time before I trusted any specialist to treat anything.
Please don't ever dismiss your patients, it has real consequences for us.

[DinoTheDinosaurROAR]

... That's crazyyyy. Because I'm always feeling chest pain, specifically speaking, it sometimes always feels like my heart is squeezing tight, or feeling like little needles are poking my chest on the inside not the outside of my chest, and also the in AND outside of my back closer to my lungs and when I experience THAT one, it gets hard to breath in all the say without it heiting and making me cough real hard over & over & over. Now, I DO in fact have asthma, ever since I was a baby, and I'm in my late 30's now and it's getting worse n worse and no I absolutely do NOT smoke cigarettes. But I have 3 different inhalers for my asthma and I also have a breathing machine called a Nebulizer with medication in these little clear vials that I twist the top off and have to squeeze that little tube of liquid medication into the Nebulizer machine and turn it on and it turns into smoke via vibration I guess Xans it turns j to smoke that I breath in and inhale and j have to keep the mask strapped to my darn face or just hold a mouth pice (it can be changed out from a mouth piece or a mask piece that you'd trap to your head and covers your nose and mouth) Anyways, I have to breath that stuff in and within 39min or less of y lungs feel much more clearer, the stsbbing/poking with a needle or tiny knife feeling goes away for thee most part but not fully but definitely for the most part and I can finally breath in ALL THE WAY!! But anyways, now, I have gone to the hospital multiple time's thru-out my life so far like ever since I was like 18 yrs old, and they kept doing an EKG and X-Ray's and MRI to look at my lungs and back, But I tell you what. Every. Single. Time. They kept on saying that my body looks fine, no issues!! And it pisses me off because of the crooked ass government, AKA the entire Left/The democrats, all doctors a nurses are trained to only pay attention to symptoms and only give medication based off the symptoms and NOT the actual issue(s) at hand to cure you, because Big Pharma/the hospital etc.. Etc.. They all make money off your return for more meds and charge your insurance up the azz because their most famous quote is "A Patient Cured, Is A Customer Lost!" and thats just frickin sad sad sad. So evil, crooked and disgusting! It's absolutely frickin horrible. It's INSANE!! They only care about money not curing you and getting down to the issue at hand to cure in no they just give you meds ontop of meds for ALL of the little symptoms you have but never a cure for the actual issue at hand!! Smh...

[edraith]

We must remember that a lot of those cases of somatic symptom disorder, most likely the vast majority, are just physicians knowing nothing about fibromyalgia, ehlers-danlos, mass syndrome, subclinical marfanoid phenotype, autism, adhd, irritable bowel, allergies, food intolerances...

I've seen thousands of cases of people who were diagnosed some 10 to 50 years after having started very appropriately describing very specific and perfect diagnostic pictures that should have led to an immediate diagnosis: in the meantime they developed a form of cPTSD from decades of medical mistreatment and in the end they had all their correct diagnoses plus the need for psychiatric support due to the huge amount of trauma developed via medical mistreatment, gaslighting, invalidation, manipulation and harassment.

[meghakaushik-vtsb]

00:01 Understanding somatoform disorders and their nature
01:36 Somatic Symptom Disorder focuses on maladaptive thoughts and behaviors.
03:07 Somatic symptoms are central to Somatic Symptom Disorder
04:41 Somatic Symptom Disorder is chronic and genuine.
06:16 Treating somatization is a major health concern
07:46 Persistent somatizers may experience worsening symptoms and increasing anxiety.
09:17 Treatment options for somatization
10:50 Diagnosing somatic symptom disorder cautiously is crucial

[lj]

I've had somatization disorder now for 12 years being diagnosed only 6 years ago. After hundreds of doctors appointments and multiple tests like m.r.i.s, ct scans, ultrasounds over that 12 year span, nothing has been found from these symptoms that I go through. I've tried meds, cognitive behavior therapy, acupuncture and almost everything in the book these past 6 years yet I still suffer from this debilitating disease. I applied for social security disability and got it right away as have just been crippled by this disease. Scary thing is that you don't know what's real and what's not. I was diagnosed with thyroid cancer last year even though I felt no symptoms for that one particular thing. It was found as I had an m.r.i. for swelling under my jaw. My shrink said to stay away from doctors while my doctor said if i'm dealing with real symptoms, i must follow up with a doctor. I feel real painful and destressing symptoms....what do I do? Any advice would be appreciated?

[Anarchist_syndicalist]

Fibromyalgia is often Misdiagnosed by doctor.

[MrAbsalomdavid]

So what is it if you DO have injuries and can point to them, but they control your time, energy, and thoughts inducing anxiety and depression?

[HUGEFLYINGWHALE]

Very problematic diagnosis. People with persistent symptoms probably do have some kind of central sensitization/small fiber neuropathy.
The number of people being discarded as psychosomatic for decades until they get a physical diagnosis is innumerable.
Youd be hard pressed to prove somatization is actually possible imo. Shitty uncaring doctors and non perfect yet scientific medical knowledge is a much more probable explanation

[MaryLee-rv]

Johnson Sharon Thomas Carol Hernandez Robert

[plockacherrys]

Holy shit they don't have any insight in their disease. I tell EM you need medication from psych and they say "I'm not crazy".

[MaryJones-de]

Jones Kenneth Davis Ronald Hernandez Betty