Symptomatology and comorbidity of somatization disorder amongst general outpatients attending a family medicine clinic in south west Nigeria

Abstract

Background: Individuals with somatization may be the most difficult to
manage because of the diverse and frequent complaints across many organ systems. They often use impressionistic language to describe circumstantial symptoms which though bizarre, may resemble genuine diseases. The disorder is best understood in the context “illness” behaviour, masking underlying mental disorder, manifesting solely as somatic symptoms or with comorbidity.
Objective: To evaluate somatization symptoms and explore its  comorbidity in order to improve the management of these patients.
Methods: A cross-sectional survey of 60 somatizing patients who were part
of a case-control study, selected by consecutive sampling of 2668 patients
who presented at the Family Medicine Clinic of University College Hospital
Ibadan, Nigeria between May-August 2009. Data was collected using the
ICPC-2, WHO- Screener and Diagnostic Schedule and analysed with SPSS
16.
Results: There were at least 5 symptoms of somatization in 93.3% of the
patients who were mostly females. Majority had crawling sensation, “headache”, unexplained limb ache, pounding heart, lump in the throat and insomnia. The mean age at onset was 35yrs with 90% having recurrence of at least 10yrs.Approximately 54% had comorbidity with cardiovascular disease being the most prevalent.
Conclusions: The study revealed that somatization is not a specific disease
but one with a spectrum of expression. This supports proposition that
features for the diagnosis of somatization could be presence of three or
more vague symptoms and a chronic course lasting over two years. It is
important to be conversant with pattern of symptoms and possible comorbidity for effective management of these patients.

Keyword: Somatization, Bizarre Symptoms, Comorbidity, Crawling sensation