SOMATIZED MENTAL DISORDERS IN PRIMARY HEALTH CARE: DIAGNOSTIC PROBLEMS AND MENTAL HEALTH INTEGRATION MODELS

Relevance. Somatized mental disorders and persistent physical symptoms are an important but often insufficiently recognized problem in primary health care. Such patients usually turn to primary health care doctors first; however, the variety of symptoms, accompanied by anxiety and depression, stigma, and diagnostic difficulties, hinders their timely detection. In this regard, it is important to integrate mental health into the primary health care system and develop interdisciplinary care models.

Objective. To systematize current evidence on the evolution of terminology, the causes of underrecognition, the tools for early identification, and the organizational models of mental health integration relevant to the diagnosis of somatized mental disorders at the primary health care level.

Materials and Methods. This study was conducted as a narrative review, with a systematic literature search across PubMed, Scopus, and Web of Science, and an analysis of documents issued by the World Health Organization, World Health Organization /Europe, and the World Organization of Family Doctors. The main focus was placed on publications from 2015 to 2025; however, earlier works of conceptual importance were also included. The initial search identified 107 publications, of which 43 sources were included in the final analysis after title and abstract screening and duplicate removal.

Conclusions. Current scientific data show that the transition from the concepts of somatoform disorders and medically unexplained symptoms to the concepts of Somatic Symptom Disorder, bodily distress disorder, and persistent physical symptoms is important for clinical practice in primary health care. The diagnosis of these conditions should be based on periodic clinical assessment, including screening tools (PHQ-15, SSS-8, SSD-12), dynamic monitoring, and functional status assessment. The integration of mental health into primary health care and the development of a multidisciplinary approach will contribute to early detection and improved access to health care.

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