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Etiological Formulations of Somatization Disorder

Somatizers are a physically and psychiatrically heterogeneous group. The diversity in the clinical manifestations of somatizers suggests multifactorial etiology. Dominant etiological factors in one patient may be f leeting or minor in another patient. The predisposing factors in somatization disorder are likely to include genetic, neuropsychological, neurophysiological, and psychophysiological, developmental learning, personality trait, and sociocultural formulations. Genetic.Guze and his associates have been instrumental in proposing a multifactorial model of disease transmission in somatization disorder.
According to their model, hysteria (i.e., somatization disorder) and sociopathy cluster in the same families. Hysteria in women is believed to be a more prevalent and less deviant form of the same process that causes sociopathy in women. Based on their research, hysterics and sociopaths mate assortatively, thereby increasing the observed similarities among relatives, but this familial clustering does not completely depend on assortative mating. Other studies have noted an increased prevalence of 20% of somatization disorder in first-degree relatives of index cases and an increased rate of marital problems, poor occupational history, social dysfunction, teenage delinquencies, alcohol problems, and sociopathy in first-degree relatives of patients. Adoption studies yielded similar findings. Although the pattern of findings from these studies is very impressive, it is very unlikely that genetics alone accounts for somatization disorder.

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