What is Doctor's Shopper Syndrome?

 

Case1: A 32 year old Male came to the clinic with complaints of Nausea, Vomiting and Abdominal Cramps. He also complained of Headache ,Dizziness and also complained of having constant Chest Pain. Test were performed regarding the cheif complaints of patient like CBC, MRI, CT scan, ECG etc. The test reports were Normal potraying no such ambiguity in a person's body. The patient was not satisfied by his report and was convinced that he had some problem in his body. After collecting the history from the patient's family members one thing came into light that coming before our clinic patient has visited to many hospitals with same complaints to many hospitals and despite of the reports being normal he still changed doctors every now and then. 

What is Somatization:  According to ICD-10 Somatization also known as Somatic form disorder is repeated presentation of Physical symptoms, together with persistent requests for medical investigations, in spite of repeated negative findings and reassurances by doctors that the symptoms have no physical basis. 

Criteria for Somatization: 

1. Not intentionally produced. 
2. Around 30 years of Age. 
3. Atleast 4 body parts involved. 
4. 2 or more GI Systems.
5. 1 Reproductive/Sexual Symptoms.
6. 1 Neurological Symptoms.
7. Multiple Complaints. 
8. Diagnostic test are normal. 
9. Level of stress and anxiety. 
10. Co-morbid Psychiatric symptoms i.e Depression, anxiety disorders etc. 

Types of Somatization:

According to DSM-5 Criteria there are 3 criteria:

Criteria A: One or more somatic symptoms that are distressing or result in significant disruption of daily life. 

Criteria B: From Criteria A it progresses to Criteria B  which leads to Excessive Thoughts, Feelings or behavior related to somatic symptoms or associated health. 

Concerns as manifested by atleast one of the following. 

Criteria C: Although any somatic symptoms may not be continously present, the state of being symptomatic is persistent for atleast 6 Months. 

Severity of Symptoms:

• Mild: Only 1 criterion B symtoms. 
• Moderate: 2 or more Criterion B Symptoms. 
• Severe: Same as moderate plus multiple somatic symptoms 

Treatment: 

1. Provide Health Education to the Client. 
2. Rule out Anxiety and Depression. 
3. Promote Coping Mechanism. 
4. Provide Cognitive Behavioral Therapy. 
5. Mindfulness based Therapy.