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Somatization and Symptoms Evaluation
Author Bios
Introduction
Defining Somatization
Detecting Symptoms
Dimensions of Symptoms
Measuring Symptoms
Psychiatric Comorbidity
Interpreting Symptom Measures
Currently selected section: Functional Syndromes and Symptoms
Etiology of Symptoms
Levels of Etiological Certainty
Strengthening Etiological Classification
Confounding Etiological Factors
Symptoms and Patient Expectations
Interpreting Patient Responses
Measuring Multiple Symptoms
Global Rating of Change
Measuring Somatization
Measuring Other Domains
Conclusions

 

Chapter 16: Somatization and Symptoms Evaluation: Functional Syndromes and Symptoms

        

 

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Selection AFibromyalgia only

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Many patients present for medical care reporting individual somatic symptoms, such as back pain, headache, dizziness, and dyspnea. However, others present with common functional syndromes manifested by constellations of somatic symptoms, such as irritable bowel syndrome (IBS), fibromyalgia (FM), chronic fatigue syndrome (CFS), temporomandibular disorder (TMD), and the highly controversial multiple chemical sensitivity (MCS).

The overlap among functional syndromes in terms of symptoms, functional impairment, psychiatric comorbidity, and response to generic treatments has been recently summarized (Aaron and Buchwald, 2001). In 53 studies that examined the co-occurrence of 2 or more syndromes in patient groups, the co-occurrence rate (overlap) was 35-70% for FM and CFS, 32-80% for FM and IBS, 58-92% for CFS and IBS, 33-55% for FM and MCS, and 30-67% for CFS and MCS.

The degree of overlap is not surprising considering how these functional syndromes are diagnosed which is predominantly or exclusively on the basis of somatic symptoms. The prevalence of individual symptoms such as fatigue, sleep disturbances, musculoskeletal pains, headache, and gastrointestinal complaints is high across all syndromes. Consequently, comorbidity with depressive and anxiety symptoms and disorders is common (Gardner et al., 2003).

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