The somatizing patient

Patients who somatize present with persistent physical complaints for which the physician cannot find a physiologic explanation. Failure to recognize this disorder and manage it appropriately leads to frustrating, costly, and potentially dangerous interventions that do not reduce suffering or identi fy occult disease. The condition is common; for example, 25% to 50% of prim ary care visits do not identify a serious medical problem as the cause of t he chief complaint.(11,14) Somatizing patients use inordinate amounts of he alth care resources. One study estimated that patients with somatization di sorder generated costs nine times greater than the average medical patient. (29) Despite this large amount of medical attention, somatizing patients re port high levels of disability and suffering, sometimes greater than that e xperienced by depressed patients.: Finally, physicians report that somatizi ng patients are among the most frustrating to treat.(17) Doctors are robbed of a sense of effectiveness because the multiple complaints neither fit in to usual diagnostic categories, nor do the patients fit into a typical offi ce schedule. Treatment outcome studies have begun to point towards manageme nt strategies and psychological interventions that reduce comorbidity and c ost of treatment, and significantly improve the doctor-patient relationship .