Psychological Medicine

Severe somatization in women is associated with altered cerebral glucose metabolism

M. HAKALA  a1, H. KARLSSON  a1c1, U. RUOTSALAINEN  a1, S. KOPONEN  a1, J. BERGMAN  a1, H. STENMAN  a1, J.-P. KELAVUORI  a1, S. AALTO  a1, T. KURKI  a1 and P. NIEMI  a1
a1 Department of Psychiatry and Department of Radiology, University of Turku, Turku PET Centre, PET Unit and Radiopharmaceutical Chemistry and Accelerator Laboratory, Åbo Akademi University, Turku; and Signal Processing Laboratory/DMI, Tampere University of Technology, Tampere, Finland


Background. Somatization is a clinical phenomenon characterized by multiple, medically unexplained somatic symptoms. The pathophysiology remains unknown. We aimed to test the hypothesis of a central nervous system dysfunction in the pathophysiology of this disorder.

Methods. We studied 10 female patients diagnosed as having somatization disorder or undifferentiated somatoform disorder with no current Axis I disorders according to DSM-IV. They were compared with 17 healthy female volunteers using brain [18F]-fluorodeoxyglucose-PET with MRI reference.

Results. The patients had lower cerebral metabolism rates of glucose (P<0·05) in both caudate nuclei, left putamen and right precentral gyrus compared with healthy volunteers.

Conclusions. This is the first study to demonstrate changes in brain metabolism in somatizing women. The regional cerebral hypometabolism is probably associated with the pathophysiology of somatization.

c1 Address for correspondence: Professor Hasse Karlsson, University of Turku, Department of Psychiatry, Kunnallissairaalantie 20, 20700 Turku, Finland