PSYCHOSOMATIC SYNDROMES, SOMATIZATION AND SOMATOFORM DISORDERS

A psychosomatic syndrome is defined as a syndrome in which psychologic al processes play a substantial role in the etiology of the illness in some of the patients. The main conclusions on the extent of the biolo gical and psychosocial contributions to several psychosomatic syndrome s are presented and the relationship of these syndromes to somatizatio n and somatoform disorders is discussed. The syndromes summarized incl ude fibromyalgia, chronic fatigue, motility disorders of the esophagus , nonulcer dyspepsia, irritable bowel syndrome, urethral syndrome, beh aviors causing disturbances of physiology, and some defined pain syndr omes. The findings suggest that the extent of the biological and psych osocial contributions vary among these syndromes as well as among indi viduals with the same syndrome. In some syndromes the extent and natur e of the biological contribution has not been established with certain ty. There is evidence to suggest that many of the phenomena of the som atoform disorders are caused by clustering of psychosomatic syndromes or their incomplete or atypical manifestations and a low sensation thr eshold. The results of the controlled studies of various methods of ps ychotherapy and drug treatments of the psychosomatic syndromes are lis ted; these studies have practical implications because the adoption of these methods is likely to enhance the efficacy of the treatment of s omatoform disorders.