common health-care response is to subject the
person to comprehensive diagnostic testing. How-
ever, test results persistently produce no apparent
physiologic cause for the symptoms. The person
may go from one doctor to another, seeking diag-
nosis and treatment for symptoms that are all too
real to the person regardless of the findings of
diagnostic tests, causing the person to remain con-
vinced he or she is seriously ill.
CHRONIC PHYSICAL SYMPTOMS COMMON
IN SOMATIZATION DISORDERabdominal pain and bloating BACK PAIN
CHEST PAIN DIARRHEA
difficulty BREATHING(DYSPNEA) dizziness
DYSMENORRHEA ERECTILE DYSFUNCTION
HEADACHE JOINT PAIN
MUSCLEweakness NAUSEA
PALPITATIONS SEXUAL DYSFUNCTION
swallowing difficulty VOMITING
Researchers do not fully understand what
causes somatization disorder, though some of its
mechanisms are clear and occur in other psychi-
atric conditions such as BODY DYSMORPHIC DISODER
andGENERALIZED ANXIETY DISORDER(GAD). Some doc-
tors may perceive the person is making himself or
herself sick (FACTITIOUS DISORDERS). Recent research
is uncovering new information about the integra-
tion among immune functions, neurologic func-
tions, and psychologic functions (the field of
PSYCHONEUROIMMUNOLOGY) that may reveal how
these body systems affect the functions of each
other in ways that shed light on conditions such as
somatization disorder.
Diagnosis of somatization disorder is often diffi-
cult because the symptoms are real (the person
experiences them, even though there are no
apparent causes) and because many people see
multiple doctors in their searches for answers.
Consistent care from the same health-care
provider is the most effective means for detecting
and diagnosing somatization disorder.
Though psychiatric treatment or counseling
could help many people understand the psycho-
logic and emotional components to their symp-
toms, another function of the disorder is the flat
refusal to acknowledge these components are
present. In many situations the person may expe-
rience side effects or complications as a result of
invasive diagnostic procedures and even surgeries.
Noninvasive treatments such as BIOFEEDBACK,
ACUPUNCTURE, and VISUALIZATION are often helpful
for people who have somatization disorder just as
they are for people who have similar symptoms
with identifiable physiologic causes. People who
can gain insight into the health relationship
between body and mind and who can use these
body–mind methods are often able to satisfactorily
control their symptoms for long-term relief.
See also CHRONIC FATIGUE SYNDROME; CONVERSION
DISORDER; FIBROMYALGIA; HYPOCHONDRIASIS; MIND–
BODY INTERACTIONS; STRESS AND STRESS MANAGEMENT.suicidal ideation and suicide Thoughts of killing
oneself, attempting to kill oneself, or succeeding in
killing oneself. The risk for suicide is highest
among people who have DISSOCIATIVE DISORDER,
clinicalDEPRESSION(major depression), SCHIZOPHRE-
NIA, and BIPOLAR DISORDER. Substance abuse and
ALCOHOLISM are also risk factors. Stressful life
events and circumstances heighten the risk and
may serve as precipitating factors. People who
have degenerative or debilitating physical health
conditions may also contemplate or attempt sui-
cide.It is important to take seriously any
comments a person makes about taking
his or her life, and to encourage the per-
son to seek help. Most communities
have suicide hot lines or crisis interven-
tion services.Suicide is intensely traumatic and very difficult
to understand for family members and friends.
Though occasional thoughts of suicide are com-
mon and most people who talk about death or
suicide make no attempts to take their own lives,
many people who carry through with suicide give
some indications (though sometimes subtle) that
suicide is at least in their thoughts. Suicide among
men is more likely to involve firearms or hanging;
suicide among women is more likely to result
from medication OVERDOSE. Loved ones often feel
responsible and guilty for missing the clues.
A common misunderstanding about suicide is
that discussing it encourages it. In most situations,suicidal ideation and suicide 385