Lifetime prevalence 0.2-3% of women and associated w positive family h/o same; 0.2% in men; onset in teen years with increased sx in 20s
Sx:Onset before age 30 yr; depressive sx; lifetime h/o 12+ (in male) or 14+ (in female) unexplained sx, multiplicity of complaints, often pain, ROS full of positives. Often include or merge w multiple functional GI disorders like globus hystericus, dysphagia, dyspepsia, irritable bowel syndrome, etc (Ann IM 1995;123:668)
Si:Normal exam
Hospitalization, procedures, false-positive test results, and clinician burnout
r/o: Conversion disorder, like hysterical paralysis or blindness, manifested by a single bizarre sx unlike the polysymptomatic pattern of somatization d/o; hypochondriasis (Nejm 1981;304:1394), which does respond at least transiently to reassurance and cognitive-behavioral rx (Jama 2004;291:1464); other functional somatic or pain syndromes