Literature Review, Somatization, Epidemiology, Etiology and Individual Factors

Physical or rather somatic symptoms are common among the adolescents as well as among children. I asked to write my essay about it best online writers. So what about their research project? The disorder may affect even adult people especially the working lot. Research indicates that there are many ways in which psychological and physical symptoms interact and under normal circumstances, there is no illness that is purely psychological or physical since it is impossible to separate the minds from the body.  In most cases, the patients show repeated physical symptoms that are medically unexplained. The aspect affects the normal functioning of the individual. Research indicates that in most cases the victim feels relentless as the symptoms are recurrent. The aspect makes him or her to fail in attending the normal duties and this affects the economic growth at large.


Somatization refers to a constellation of clinical as well as behavioral features that a person is either experiencing psychological distress or physical illness that can’t be accounted for medically. The aspect means that the physicians as well as the victims can’t identify the exact cause of the symptoms. The physicians are in most cases left in dilemmas as the condition mimics other diseases. The patient thus receives medication from time to time which doesn’t fully help him or her recover. The pressure of taking drugs as well as not recovering makes the victim to lose hope in medication and the aspect worsen the condition. The victim may end up shifting from one physician to another as well as receiving treatments of certain condition from one health facility to the other. It is worth noting that in somatization, the aspect of producing these symptoms is not under social control. However, among the young people as well as children, the establishment of the level of conspicuous control is somewhat difficult.

Somatoform disorders usually presents repeated primary care by healthcare practitioners. The aspect is due to the fact that the symptoms are not associated to any psychological cause. The disease burdens the entire society. The parents of the suffering patients spend most of their resources as well as time to take care of their ill kids. The fact that the symptoms are recurrent makes these parents to consult different physicians. The aspect makes them lose more funds. In most cases, the parents don’t report in their work places as they seek medication ion behalf of their kids. In the long run more working days are lost. The parents of these victims are then pressured by the issue of reporting for their duties as well as the sickling children. The parents are then affected by similar symptoms that are in most cases stress related. The parents then take sick –off leaves of fails to report for their duties. The organization in the long run fails to meet its potential target as some of her key players are ill. Such loss of days as well as resources affects the entire economy as well. The aspect is due to the fact that the employers who should be working remain absent due to illness. The workers who are left in the premises at the end are pressures by the increased work load. If the situation persists, the working lot may be affected due to the increased pressure. In the long run, lack of enough rest as well as stress may cause the working lot to experience similar symptoms that may force them not to attend their duties. The disease thus becomes detrimental to each and every person in the economy.


Little information is known about the exact cause as well as the prevalence of somatoform disorders. However, the epidemiologies of the disorder that are related to somatization are general and unexplained medically. The most common somatic symptoms include abdominal pains, muscular and joint pains, headaches as well as general body weakness. The worst part of the disorder is that the symptoms are recurrent even after inductive treatment. In many nations, somatization is linked to low social economic status. In Germany, more than 12% of people aged 14-24 years are reported to have suffered in one of the somatic disorders.  In the US, young people as well as children are reported to be mostly affected by this disorder. It appears as if there are uneven distributions of the chronic syndromes of the disorder across the western countries. In most cases, pain as well as the undifferentiated disorders starts in childhood as well as on early adolescence. The abdominal pains frequencies increase as one age. Among the working lot in the society, headaches as well as muscle and joint pain are common. It is worth noting that most of these somatic symptoms as well as disorders occur more in women than they do to men.


There are a number of factors that causes somatization.  A number of family, individual as well as environmental have been associated with the predisposing as well as precipitating causes of somatization. In most cases, people with conscientious, sensitive or anxious feelings are vulnerable to somatization.

Individual Factors

People with a history of emotional labiality as well as anxiety are at a high risk of developing this disorder.  Among many individuals, the precipitating factors of these symptoms include social stressors such as comments from school or at work places. In most cases, objective stressors are not severe. However, when they are combined with anxiety temperament, they are interpreted with more severe symptoms of somatization. There should be careful consideration given to the existence of other common stressors such as school related stress or work- related stress as well as abuse. It is worth noting that previous abuse or even stress may be a precipitating effect that can increase the risk of somatization.  Researchers indicate that the maintenance of somatization symptoms can be mediated by traits that are temperamental to the victim. People who have a difficulty in adjusting these to these traits should be helped in an attempt of lowering the risk of developing the condition.

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Family and Environmental Factors. Rationale of the Study

Emotionally over- involved family, anxious as well as over –protective families may predispose a person to development of somatization symptoms. It is worth noting that in families that have certain health problems within it, the children born out of these families may develop unexplained medical conditions that mirrors the family`s illness. In addition, existence of physical problems as well as somatization symptoms within the family exposes the upcoming lineage. Chronically stressful situations in most cases predispose the children of such a family to the re-occurrence of the symptoms. Parent’s distress over the un-healing children conditions exposes them to more illness that exposes them to somatization. In a nutshell the distress created out of the development of unexplained medical conditions among the children exposes the parents to chronic distress that leads to somatization. The parents are put into a position that they can`t offer the best care to their children as they also fail to work efficiently. The anxiousness created exposes them to more risks of somatization.      Any illness in the family affects each and every person. For instance if a child is sick, the parents are forced to have decreased leisure time as most of their time is spent while taking care of the kid. On the other hand if a parent is sick, he or she will not attend the duties allocated to him or her effectively. In the long run, the entire society suffers as it tries to offer medical intervention to the sick victim.

Environmental Factors

Academic pressure, peer problems, work-related pressure as well as relationships with work-colleagues as well as teachers may expose both the children as well as the parents in a certain family to somatization. The aspect is due to the fact that back at school the children may not be in a position to absorb all the pressure put in from both her fellow students as well as from his or her teachers. The aspect may expose the child to somatization that may end up affecting the parents. The parents on the other hand may fail to meet all the assigned duties due to the pressure created in their work- places as well as within their family members. In the long run, the entire society is exposed to somatization that may end having negative implications to the economy. The aspect is worsened by the fact that more days are lost as the victims seek medical attention from time to time. The other aspect that makes the debut of this condition to be worse is the fact that most of these symptoms have no relationship with any physiological process such that they are medically unexplained. The parents as well as the victims affected end up sufferings from to time to time and in the long run the whole society suffers. Organizations therefore need to re-organize its duties allocation such that incase of such a situation, their standards are maintained and the working lot aren’t affected by increased work-load. Premises should also ensure that the working schedules are well arranged to minimize any related distress to her workers.

Rationale of the Study

Within the NHS there is a variation in sickness absence rates amongst staff groups [n’s sickness rates]. In England in 2016, NHS Digital reported on sickness absence data compiled from the electronic staff record (ESR) over a six month period. Whilst it has been shown that there is variation in the quality and accuracy of this data, it illustrates overall trends that healthcare assistants (HCA) and ambulance staff had the highest sickness absence rate at 6.25% compared to nursing, midwifery and health visitor students at 1.13% [n’s sickness rates]. Whilst the factors that affect HCAs and ambulance staff leading to this apparent difference have not been studied, it is feasible that the SA demonstrated is influenced by the psychosocial aspects of work. Occupations which impose a risk of poor psychological outcomes have features in common such as job strain; high job demands coupled with low decision latitude, imbalances between effort and reward, support and satisfaction [Sergio]. Imbalance of work and socially defined rewards, such as salary, promotion and recognition, is recognized stress trigger [Sergio]. Healthcare workers who enter the profession to help others may have intrinsic tendencies to over commit to their work, and this group of people, are particularly affected by this type of work related stress. Health risks therefore depend on personal characteristics in addition to the type and place of employment.

Sickness absence is an established surrogate marker for the health of the working population, with strong associations between sickness absence rates and various measures of health [Ferried]. As illustrated earlier, within the NHS the highest cause of SA remains MSDs and attempts to prevent SA have mainly focused on addressing the physical demands of the job. Occupational physicians have tried to prevent MSDs by altering working practices, as they have assumed that ergonomically badly designed workplaces are the primary cause of MSDs. The traditional school of thought is to follow a hierarchy of controls to protect the worker. Tasks have been ergonomically modified to reduce the physical demands on the human body with the aim to minimize tissue injury such as those thought to cause back pain [coggon turning point]. In addition, modern technology has replaced tasks traditionally undertaken by manual labourers and reduced the overall size of the workforce in the manufacturing sector [coggon turning point]. In the NHS, manual handling techniques are taught and the use of hoist employed rather than lifting bed bound patients. Despite this reduction in exposure, the rate of sickness absence attributed to back pain has not decreased as would be expected but increased by a factor of 8 over 40 years [turning point].

The biophysical paradigm (the traditional disease model) does not fully explain the presentation and symptoms of physical disorders of individuals with MSD such as back pain. There is often no pathological cause or the tissue injury does not correlate well to the level of pain and disability. Coggon makes a key distinction between disease and illness that is important when considering causation of sickness absence. Disease is a pathological process that is amenable to objective, external verification. Illness, however, is a subjective state – an indication of how the person feels and their experiences. It may be thought of as the human response and hence may be due to an organic disease or a psychological process. Illness and disease may coexist although they do not always do so [turning point]. A person may have a disease but is asymptomatic and hence do not consider themselves to be ill. Comparably, a person may have no identifiable disease but feels unwell and demonstrates illness behaviour. Simultaneously, research has shown that poor mental health can adversely affect pain and recovery []. Pain is always subjective and defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage []. Pain can persist in the absence of noxious stimuli implying that the subjective and emotional components take a more central role in the causation when poor mental health coexists. This has led researchers to propose the biopsychosocial model, to explain illness behavior. Pain and coping behaviors are influenced by culturally determined health beliefs [Sergio]. Stigma and cultural beliefs amongst healthcare professionals regards mental health conditions often leads to fear of accessing appropriate medical assistance, which is believed could be detrimental to career progression. A culture exists to devalue psychological suffering as compared to physical pain. Illness and sickness behavior secondary to physical diseases is therefore more acceptable. Humans can express emotions through a physical response, some of which are voluntary whilst others are not. Sadness produces tears, embarrassment a red flush of the skin. Stress, anxiety or worry can induce a headache, fatigue and pain. Most people would accept that these physical symptoms are normal and transient manifestations of their emotional state. Others however, find that their behavior around these symptoms changes, causing them to disproportionately worry and focus on these symptoms.  It follows that illnesses that lead to sickness absence where pain is a prominent feature, may not necessarily secondary to a pathological process amenable to conventional treatment, but may be a psychological response to a stress.

The CUPID study showed that there is a strong association between non-specific musculoskeletal complaints and a general tendency to report somatic symptoms [cupid]. Somatising tendency (ST) is defined as a predisposition to be unusually aware of, and to worry about, common somatic symptoms [des epic coggon]. Cultural influences and personal characteristics make certain individual more susceptible to have a Somatising tendency.  Somatization refers to the tendency of a person to have physical symptoms in response to stress or emotions [o’sullivan].It has been demonstrated to be a stable trait and contributes to differences in sickness behavior and sickness absence rates amongst different occupational groups and cultures [des epic, cupid]. Understanding the characteristics of NHS workers with ST and identifying its descriptive epidemiology could be helpful in tackling sickness absence rates. SD sickness absence rates have not declined over the years despite several interventions. Perhaps it is time our approach is changed by understanding the psychological risk factors predisposing to these illnesses and addressing them accordingly.

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Introduction and Background Information

Somatizing tendency refers to a certain predisposition where one worry about common somatic symptoms. The aspect is associated with certain aspects of health-related behaviors such as musculoskeletal pain as well as associated disability. The condition can be measured using instruments such as Somatic Symptom scale, Scale derived from the Brief Symptom Inventory as well as the Modified Somatic Perception Questionnaire. Most of these symptoms include the muscular pain especially at multiple pains, medical consultation, and sickness absence from work as well as dissatisfaction with most medical care.  Research indicates that this kind of pain has been associated with cross-section indicating the tendency to somatize predicts although it is not simply a consequence of other health aspects. In most cases, the absence from work, whether planned or unplanned, is in most cases associated to ill health of both the employees as well as the employer. Research indicates that in UK, the monetary cost to the British economy was about fifteen billion pounds. Out of the cost, about 130 million days were lost during working. Taxpayers in most cases fund about 13 billion pound on aspects that are related to health. About 2 billion pounds were directed to healthcare as well as reimbursement of sick pay as well as other taxes.  The aspect indicates that the consequences of employees  being absent from not only affect the monetary values in the economy but also the social as well as the psychological issues that further perpetuates incapacity from work.

A survey conducted by the Absence Management Survey 2016 reveals that the aspect of sickness absence rates affected the public sector more than the private sectors. In fact 5.7 days were lost in the private sector, 8.8 days among the non- profit organizations and 9.1 days were lost in the private sector. The ratings were done yearly. The reasons that were behind all these lose were due to the multifactorial factors. Such factors include the demographic values of the employees, the financial incentives as well as the work value instilled in various organizations. The research indicate that the highest loss of days related to sickness were among the health workers which averages at 3.4% hours. Absenteeism among the health workers is more risky in relation to other sectors. The aspect is due to the fact that the worker in the health-sector guarantees safety as well as soberness among other workers. In most cases, absenteeism among the health workers may as well affect other sectors.

There are different sectors that are critical in a nation’s economy. In UK the NHS differs from other public sectors in that it uses different workforce in terms of skillsets as well as occupations. A 24-hour system a day is deployed in NHS. The aspect means that the organization ensures that all its operations run for 365 days in a year. The aspect creates a specific working environment to the staffs in NHS. However, the trends in the sickness absence rates are higher in NHS in relation to other public organizations. High sickness absence rates in an organization such as NHS, increases the work load pressure on the remaining workers in the premises to work hard in their bid to absorb the additional work-load as well as maintain high standards of patient care. In most cases, the work-load may exceed the staff expectations. The aspect suggests that the organization need to adjust its program as well as increase the number staffs to cater for the risks that are associated with absenteeism. The program needs to be adjusted as more pressure may affect the working staff and more stress may be accumulated thus leading to more absenteeism.

Background Information

As pointed out earlier, Somatizing tendency refers to a situation where one worries about common symptoms. It is worth noting that these aspects are related to healthy as well as its related behaviors. The behaviors include musculoskeletal pain as well as associated disability. The somatization disorder is a manifestation of stress-disorder that is characterized by symptoms that mimics disease as well as physical injuries that have no identifiable cause. In most cases, the physical symptoms have no identifiable reason and result in multiple visits to the physicians as well as unsatisfactory lab exanimations. The symptoms may persist for years and the patient become dissatisfied by the physician. There are cases where the patients seek spiritual interventions of their illness as they blame their symptoms on some past spiritual attack as results of some past sins. Usually a discerning physician would unravel the problem for the benefit of the patient.

The impact of this disorder in most cases affects the social economic aspects of the victims as well as their working fluency. Since the individual present with various symptoms, absenteeism at work places becomes a norm. Other symptoms such as depression, suicidal tendencies, somatizing disorders as well as anxiety neurosis are common among these victims. The symptoms in most cases cause the person to be absent in her area of work.  Stress as well as other related symptoms impacts the quality of service that is offered by these workers. The other effect is that their regular visits to the physicians cause them to be absent and as a result a lot of days are lost in the end. Research indicates that these victims are likely to cause accidents even at their work places. Lack of motivation as well as poor commitment of the staff affects the visions of their premises negatively. The aspect is due to the fact that, when these victims are working, due to stress as well as somatizing disorders, they are less motivated and their efficiency lowers. The other loss that affects most of these premises is the fact that the victim’s symptoms cause them to seek medical attention time to time. As a result more pressure is piled to the working lot such that more stress is built up. The aspect may affect the entire organization due to pressure to maintain the same quality of service. The effect may extend to the healthy works duet to issues of fatigue. The fatigued workers are in turn unable to work efficiently after a period of time. The organization may in turn be forced to employ more workers to meet their standards. It is worth noting that the organization may end up paying workers that are not working. The aspect may affect the general development of the organization. More funds are diverted to pay workers that are called in to work on behalf of the absent workers.

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