Somatization, distress and chronic pain.

The two defining features of somatization are numerous self-reported physical symptoms and excessive health care seeking. This may be due to a lowered perceptual threshold for perceiving and reporting bodily symptoms, amplification or misinterpretation of those symptoms, or underlying psychiatric disturbance. Recurrent pain is the most common somatic symptom reported. True somatization disorder is very rare (< 1%) and requires a DSM-III-R diagnosis of at least 13 different physical symptoms which cannot be explained by, or are in gross excess of physical findings, and have caused the patients to seek health care or alter their lifestyles. However, researchers have argued that a spectrum of severity for somatization exists, and this is supported by epidemiological research. Available data also indicate that behavioural interventions may show long-term cost-effectiveness in the management of chronic pain. Chronic pain dysfunction appears to place a disproportionate burden on overall health care expenditure for chronic pain patients.