12.1 Headache attributed to somatization disorder[^1]

Identification: Female patient, 29 years old, presenting with daily headache for 14 months. History of Present Illness: Pain: Location: Vertex and bilateral occipital region Characteristic: Diffuse pressure ("helmet"), fluctuating intensity (3-7/10) No pulsatile characteristics or autonomic phenomena Psychosocial context: History of generalized anxiety (irregularly treated) Chronic marital and work-related conflicts Excessive concern about the pathological significance of the pain Concomitant somatic symptoms: Chronic fatigue Non-specific low back pain Functional dyspepsia Physical/Neurological Examination: Complete neurological assessment: Normal Cranio-cervical muscle palpation: Diffuse hyperalgesia without specific trigger points Psychiatric evaluation (SCID-5): DSM-5 criteria for somatic symptom disorder PHQ-15 scale: 18/30 (high level of somatization) Complementary Examinations: Brain MRI: Normal Transcranial Doppler: Symmetrical cerebral vascular flow Psychological assessment: Beck Depression Inventory: 16 (mild) Hamilton Anxiety Scale: 22 (moderate)