Elevated levels of psychophysiological arousal and cortisol in patients with somatization syndrome

Objective: This study investigates psychological and psychobiological processes in patients with somatization syndrome. Method: We compared physiological measures (heart rate, finger pulse volume, electrodermal activity, electromyography), cortisol levels, and subjective well-being during rest and during a mental stress task as well as selective attention and memory for illness-related words in 58 patients with somatization syndrome and 21 healthy controls. Results: The somatization group had higher morning salivary cortisol concentrations, higher heart rates, and lower levels of finger pulse volume. During the mental stress task, patients with somatization syndrome felt more distressed and had higher heart rates, whereas controls showed habituation to the experimental situation. We were unable to demonstrate an attention or memory bias specific for somatization. Conclusions: The results point to several psychological, psychophysiological, and psychobiological mechanisms that might be involved in the maintenance of somatization syndrome. These results are discussed from a cognitive-psychobiological perspective.