Somatization in primary care. The common presentation of psychosocial problems through physical complaints.

Somatization is a common problem in primary care. It has been estimated that up to 75% of all visits to primary care providers involve presentation of psychosocial problems through physical complaints. The patient with an acute problem may respond to education, support and reassurance. The chronic somatizer often has a history of inadequate coping, painful interpersonal relationships, and frequent but unsatisfying relationships with health care providers. The etiology of somatization involves a combination of social, psychological and cultural variables. A careful and holistic assessment of complaints and psychosocial aspects is vital in order to avoid extensive diagnostic evaluations and treatments which do not help and may put them at risk for iatrogenic illness. Specific strategies that emphasize a caring, supportive relationship are useful. The NP may need consultation from medical and mental health colleagues to assist in the behavioral management of the chronic somatizer.