Survey and Research for Mechanisms of Somatization of General Out-patients

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Recent increments of senile population and medical information have enhanced anxiety and attention for own somatic conditions, resulting in vicious circles converting psychosocial stressors into somatic problems. The convertion or somatization produces lots of the patients with "medically untreatable somatic conditions", and brings about medico-economical problems with frequent examinations and excessive pharmacotherapy. Thus we investigated social, familiar and psychological factors behind the somatization.Two hundreds and forty-nine out-patients, visiting a clinic of either internal medicine psychosomatic medicine or psychiatry, answered the questionnaire of socio-psychological factors and selected the present symptoms among the somatization symptom list. The doctor in charge judged predominance of psychological and somatic effects on each symptom and the patients were classified into 4 groups of "No Sympton", "Psychological Predominance", "Somatic Predominance" and "Mixed Effects".The main results were as follows : (1)the patients with "Psychological Predominance" briefly called somatized patients were 37% of the total patients and the sex ratio of male vs. female was 1 : 3.6. The incidence was the highest (74%) in the psychiatric clinic but 12% of the internal patients were somatized. (2)Somatization symptoms could be determined within one month evaluation. (3)The somatized patients showed the following tendencies : they had grown up in the extended families who were sickly and hated mental problems, they led the school life where they had been enthusiastic about sports but indifferent to friendship and health and delayd in physical development, and now they had few pleasures and friends, were indifferent to exercises and healthy circumstances, and used some tranquilizers and hypnotics almost daily. They showed characteristics such as perfectionism, apprehensions and loneliness, and had some hypochondrical ideations.