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Somatization disorder has been recognized since the time of ancient Egypt. An early
name for somatization disorder was hysteria, a condition incorrectly thought to
affect only women. (The word hysteria is derived from the Greek word for uterus,
hystera.) In the 17th century, Thomas Sydenham recognized that psychological
factors, which he called antecedent sorrows, were involved in the pathogenesis of
the symptoms. In 1859, Paul Briquet, a French physician, observed the multiplicity
of symptoms and affected organ systems and commented on the usually chronic
course of the disorder. Because of these clinical observations, the disorder was
called Briquet's syndrome until the term somatization disorder became the
standard in the United States.
Epidemiology The lifetime prevalence of somatization disorder in the general
population is estimated to be 0.2 percent to 2 percent in women and 0.2 percent in
men. Women with somatization disorder outnumber men 5 to 20 times, but the
highest estimates may be because of the early tendency not to diagnose
somatization disorder in male patients. Nevertheless, it is not an uncommon
disorder. With a 5-to-1 female-to male ratio, the lifetime prevalence of somatization
disorder among women in the general population may be 1 or 2 percent. Among
patients in the offices of general practitioners and family practitioners, 5 to 10
percent may meet the diagnostic criteria for somatization disorder. The disorder is
inversely related to social position and occurs most often among patients who have
little education and low incomes. Somatization disorder is defined as beginning
before age 30; it usually begins during a person's teenage years. Several studies
have noted that somatization disorder commonly coexists with other mental
disorders. About two thirds of all patients with somatization disorder have
identifiable psychiatric symptoms, and up to half have other mental disorders.
Commonly associated personality traits or personality disorders are those
characterized by avoidant, paranoid, self-defeating, and obsessive-compulsive
features. Two disorders not seen more commonly in patients with somatization
disorder than in the general population are bipolar I disorder and substance abuse.