Somatization: a psychiatrist's perspective

Psychiatrists are referred only a small and unrepresentative proportion of patients who somatize. To a large extent this is due to the fact that patients consider themselves physically ill and regard psychiatric referral as inappropriate. Although somatization has several social advantages it obscures underlying psychopathology and leads to unnecessary physical investigations with a risk of iatrogenic disease. It is important to establish a psychiatric diagnosis as early as possible so that treatment can be started before a chronic pattern of illness behaviour is established.