Misidentification of causal sources may be more common in cross-cultural settings because of the recognized tendency among some groups to somatize their distress. This can be treacherous ground even for the medically trained clinician. Assuming that a somatic symptom is due to somatization of distress may be just as erroneous as the opposite focusing on a somatic symptom as though it had no emotional component and perhaps needlessly pursuing it diagnosti-cally. I recently saw a Mexican American man with what to me were bizarre somatic abdominal complaints that did not conform to any recognized medical condition, who had undergone an exploratory laparotomy in a fruitless search for organic pathology. None was found.
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