Trastorno por somatización: su abordaje en Atención Primaria

somatisation as such is not a psychiatric diagnosis, but is a common denominator of a number of disorders described by the dsm-iv (diagnostic and statistical manual of mental disorders) as somatoform disorders. somatform disorders are diagnosed by the presence of body symptoms that suggest a physical disorder without a demonstrable organic cause or known physiological mechanism that fully explains them and by the reasonable presumption that these symptoms are related to psychological factors or stress. patients with chronic, serious somatoform disorders (mainly somatisation disorder, hypochondriasis, body dysmorphic disorder, and psychogenic pain) also present with personality disorders that determine the evolution or are even the main diagnosis. in addition, these patients frequently present/display severe psycho-social stress when they go to the doctor and have social adjustment problems, which often reinforce the symptoms. the gains derived from the disease and the role the patient assumes, the anomalous cognitive-perceptive mechanisms and the doctor-patient relationship are all essential for the understanding of the configuration process of many somatoform disorders and for determining their treatment. primary care doctors therefore should be aware of and consider somatisation disorders in their clinical practice because many of the patient's symptoms could be an expression of their emotional difficulties that summarize complex psychological, life, family and social interactions, that may jeopardize the doctor-patient relationship.