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The unbearable lightness of somatisation: A systematic review of the concept of somatisation in empirical studies of pain

Crombez, Geerta,*; Beirens, Koenb; Van Damme, Stefaana; Eccleston, Christopherc; Fontaine, Johnnyb

doi: 10.1016/j.pain.2009.04.006

ABSTRACT Somatisation is often invoked to explain pain and suffering in patients. Lipowski [34] defined somatisation as “a tendency to experience and communicate somatic distress and symptoms unaccounted for by pathological findings, to attribute them to physical illness, and to seek medical help for them” (p. 1359). His concept is widely accepted. This study investigated to what extent this conceptualisation is used in the empirical studies of pain. Studies were identified through searches from Web of Science, Pubmed and Psychinfo databases for the period from 1989 until 2007. Screening an initial set of 1020 articles resulted in 120 articles fulfilling inclusion criteria. One hundred and sixteen articles were retrieved and coded in terms of the conceptualisation of Lipowski [34]. All studies had a measure of somatic symptoms, most often questionnaires. Whether the symptoms were unaccounted for by pathological findings was rarely investigated. No study assessed whether the participants attributed the somatic complaints to physical illness. Most studies included patients seeking help in a clinical setting, but only one study investigated whether patients were seeking help for the somatisation complaints. In conclusion, no study fulfilled the construct criteria as defined by Lipowski [34]. Most studies focus upon the extent and diversity of somatic complaints. We recommend that researchers who use self-report instruments do not use the term “somatisation” (even if the instrument is labeled as a “somatisation” scale), but use the term “multiple physical symptoms” instead. The current operational use may unduly lead to a “psychologisation” of physical complaints.

aDepartment of Experimental-Clinical and Health Psychology, Ghent University, Belgium

bDepartment of Personnel Management, Work, and Organisational Psychology, Ghent University, Belgium

cCentre for Pain Research, The University of Bath, UK

*Corresponding author. Address: Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium. Tel.: +32 (0) 9 264 64 61; fax: +32 (0) 9 264 64 89.



Article history:

Received December 16, 2008; Received in revised form March 5, 2009; Accepted April 9, 2009.

© 2009 Lippincott Williams & Wilkins, Inc.
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