Somatization disorder: Are we moving towards an over-generalized and over-inclusive diagnosis in DSM-V?

Abstract

Introduction: The confusion around the diagnosis of ‘medically unexplained symptoms’ has lead to a paradigm shift in criteria for diagnosis of somatization disorder. Aims: 1. To compare the socio-demographic variables in patients of somatization disorder 2. To compare the levels of depressive and anxiety scores of patients of somatization disorder along with the severity of disorder. Material and Methods: Somatization patients visiting the psychiatry outdoor of TMMC & RC, were randomly selected and diagnosed as per DSM-IV TR. After obtaining informed consent and applying exclusion criteria, demographic and clinical details were obtained on a self designed Performa. The HAM-A scale and MADRS scale were applied to calculate anxiety and depression scores. Results: The prevalence of somatization disorder was 2.35% in men and 6.7% in women. Females were significantly higher in number. Headache was the chief complaint. The anxiety scores and MADRS scores were highest in patients complaining of chest pain. The HAM-A and MADRS scores increased significantly as number of complaints increased. Female patients and patients belonging to rural background had significantly higher number of complaints. Illiterate patients had a significantly higher duration of illness. Conclusion: Somatization disorder comprises unique group of patients with high co-morbidities and longer duration of illness. It is imperative to identify and clarify severity of this subgroup as treatment decisions need to be modified accordingly.

Keywords

• Somatization
• DSM-V