Somatization Disorder and Undifferentiated Somatoform Disorder Introduction

Patients with somatization disorder or undifferentiated somatoform disorder are frequently vexing to treat.¹ At the same time, these patients are severely disabled by their disorders. Their treatment involves management difficulties that usually result in poor treatment outcomes and frustrated health care providers. Recent work has begun to shed light on treatment approaches that can result in improved outcomes for these difficult-to-treat patients, lower health care costs, and more satisfied health care providers.

Treatment of somatization disorder or undifferentiated somatoform disorder has five specific aspects: 1) recognizing these disorders as diagnostic possibilities, 2) making the correct diagnosis, 3) understanding the course of the patient’s disorder and assessing the patient’s symptoms, 4) following general management approaches, and 5) using specific treatment modalities. I address each of these areas in detail to provide the rationale for a broad treatment approach to these two disorders.

¹ Throughout this chapter, a distinction is made between somatization disorder and undifferentiated somatoform disorder. Many, including myself, contend that undifferentiated somatoform disorder is simply a milder version of somatization disorder. However, only limited empirical information supports this contention. Furthermore, because there are virtually no treatment data on undifferentiated somatoform disorder, most of the discussion concerning this disorder is extrapolated from discussions of somatization disorder. These extrapolations are noted in the text.