somatization

Somatization refers to the experience and reporting of physical symptoms that suggest illness but for which there is no sufficient medical explanation, or where symptoms are disproportionate to any underlying disease. It describes a pattern in which psychological distress, conflict, or emotions are expressed as physical complaints across multiple organ systems rather than as a single localized illness. The concept is used in both research and clinical practice to understand how distress can be manifested somatically.

In modern diagnostic terminology, the term somatization is largely encompassed by somatic symptom disorders. The DSM-5 defines somatic symptom disorder as one or more persistent somatic symptoms that are distressing or result in significant disruption of daily life, accompanied by excessive thoughts, feelings, or behaviors related to the symptoms. The previous category of somatization disorder, along with related diagnoses such as undifferentiated somatoform disorder, has been updated or reorganized within this framework. It is important to differentiate somatic symptom disorders from conditions involving intentional symptom production, such as malingering or factitious disorder.

Causes are understood through a biopsychosocial model, incorporating biological factors (such as genetic or neurobiological influences), psychological processes (such as attention to body sensations, coping styles), and social or cultural factors that shape how symptoms are perceived and described. Cultural norms can influence the types of symptoms that are emphasized and the willingness to seek care.

Treatment typically involves a collaborative, multidisciplinary approach. Regular, nonjudgmental primary care follow-up, psychotherapy (notably cognitive-behavioral therapy and sometimes interpersonal therapy), and treatment of co-occurring anxiety or depressive disorders are common components. Education about the mind–body connection and functional rehabilitation strategies can help improve functioning and reduce symptom burden.