The aetiology of somatization disorder is unknown, but it is probably multifactorial. It is beyond doubt that an important biological component is involved, although the specific nature has still to be revealed. Whether the cognitive and other typical disturbances develop as a consequence of a basic biological defect in an interaction with the patient's life experiences, or they and other predisposing factors have an independent impact is, as yet, unresolved.

From a psychodynamic point of view the theory of self-psychology seems important, but not the classical psychodynamic drive theory. Course and prognosis

Patients with somatization disorder are usually chronically ill for most of their lives. However, there can be periods of partial, but seldom full, remission. (1.) Some patients are able to work, although others are severely disabled and are chair- or bed-bound and their families have to provide virtually all physical aspects of care. Patients with somatization disorder are often subjectively more functionally handicapped than patients who have a comparable, yet fully explained, medical condition.

Patients who have a treatable comorbid affective or anxiety disorder may have a more favourable prognosis.

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