1. Introduction

Somatization disorder (now classified under Somatic Symptom Disorder in DSM-5) and related Functional Somatic Syndromes (FSS)—such as irritable bowel syndrome (IBS), fibromyalgia, and chronic fatigue syndrome—refer to conditions where patients experience persistent physical symptoms without an identifiable medical cause.
These symptoms are real, distressing, and often lead to significant impairment in daily life, even though they cannot be fully explained by structural or biochemical abnormalities.

2. Symptoms

Symptoms vary widely, but common features include:

• General physical complaints: Pain, fatigue, dizziness, weakness.
• Gastrointestinal symptoms: Nausea, bloating, abdominal pain, diarrhea/constipation (e.g., IBS).
• Neurological symptoms: Headaches, tingling, memory issues.
• Musculoskeletal symptoms: Muscle or joint pain, stiffness (e.g., fibromyalgia).
• Autonomic symptoms: Palpitations, sweating, shortness of breath.
• Psychological distress: Anxiety, excessive health worries, frequent medical visits.

Symptoms usually persist for months or years, fluctuate in intensity, and are often worsened by stress.

3. Causes (Multifactorial)

The exact cause is not fully understood, but major contributing factors include:

• Biological:
  • Dysregulation of the brain–gut or brain–body axis.
  • Altered pain perception and heightened sensitivity to bodily sensations.
  • Neurotransmitter imbalances (serotonin, norepinephrine).
• Psychological:
  • Health anxiety, catastrophic thinking.
  • Maladaptive coping mechanisms.
  • Past trauma, abuse, or chronic stress.
• Social:
  • Cultural beliefs about illness.
  • Reinforcement of “sick role” (frequent medical visits, attention).
  • Family history of somatic symptoms.

4. Treatment

Aims to reduce distress, improve functioning, and prevent unnecessary medical interventions.
Key approaches:

• Psychological interventions:
  • Cognitive Behavioral Therapy (CBT): Helps modify maladaptive thoughts about symptoms.
  • Mindfulness-based therapy: Reduces stress and bodily hyperawareness.
• Pharmacological treatment:
  • Antidepressants (SSRIs, SNRIs, tricyclics) for pain, mood, and sleep.
  • Limited role for analgesics; avoid long-term opioids.
• Lifestyle & supportive management:
  • Regular exercise, relaxation techniques.
  • Structured daily routine, sleep hygiene.
  • Patient education: reassurance that symptoms are real but not life-threatening.
  • Coordinated care to prevent unnecessary investigations and doctor-shopping.

5. Prevention

While not all cases are preventable, the risk can be reduced by:

• Early management of stress, anxiety, and depression.
• Promoting healthy coping strategies (resilience, problem-solving, relaxation).
• Encouraging balanced lifestyle: Exercise, sleep, diet.
• Good doctor–patient communication to validate concerns and reduce unnecessary medicalization.
• Health education to correct misconceptions about normal body sensations.

✅ In short:
Somatization disorder and functional somatic syndromes are real, distressing conditions without a clear organic cause, rooted in complex interactions between mind and body. Management requires a holistic, biopsychosocial approach that validates the patient’s experience while avoiding unnecessary medical interventions.