Somatic Symptom Disorder

Somatic symptom disorder is characterised by one or more chronic physical symptoms accompanied by significant and out-of-proportion levels of distress, worries, and difficulty in daily functioning related to those symptoms.

  • Individuals with somatic symptom disorder are preoccupied with their symptoms and spend excessive amounts of time and energy on these symptoms and health concerns.
  • Medical professionals diagnose the disorder when individuals continue to be preoccupied and concerned with their symptoms after physical disorders have been ruled out or when their response to their physical disorder is unusually intense.
  • Psychotherapy, particularly cognitive-behavioural therapy, can help, as can having a supportive, trustful relationship with a medical profesional.

Somatic symptom disorder replaces several previously used diagnoses, such as:

  • Somatisation disorder;
  • Hypochondriasis;
  • Pain disorder;
  • Undifferentiated somatoform disorder; and
  • Some other related disorders.

All of these disorders involve somatisation – the expression of mental factors as physical (somatic—from soma, the Greek word for body) symptoms.

In this disorder, the individual’s main concern is with the physical symptoms, such as pain, weakness, fatigue, nausea, or other bodily sensations.

The individual may or may not have a medical disorder that causes or contributes to the symptoms.

However, when a medical disorder is present, an individual with somatic symptom disorder responds to it excessively.

Medical professionals used to diagnose this type of mental health disorder (sometimes called psychosomatic or somatoform disorders) when individuals reported physical symptoms that were not explained by a physical disorder.

However, the approach is problematic for several reasons:

  • It is sometimes difficult for medical professionals to determine that an individual has no physical disorder.
  • It is not usually appropriate to diagnose an individual with a mental health disorder simply because medical professionals cannot find a physical cause for the symptoms. Test results could have been wrong, or the wrong tests could have been used.
  • Many individuals may have a physical disorder that contributes to their symptoms, but they react so excessively or inappropriately to it that they are considered to have a mental health disorder.
  • Making such a distinction between physical and mental symptoms sometimes makes people think that medical professionals do not believe their symptoms are real.

Because of these problems, medical professionals now base the diagnosis of somatic symptom disorder on how individuals respond to their symptoms or health concerns.

The main criterion for diagnosing somatic symptom disorder is the following:

  • The individual’s preoccupation with their physical symptoms is so strong that it causes significant distress and interferes with daily functioning.

Individuals with somatic symptom disorder do not intentionally produce or pretend to have the symptoms, and the symptoms may or may not be associated with another medical problem.

Individuals who have somatic symptom disorder and another medical problem may overreact to the medical problem. For example, after a heart attack, they may completely recover physically, but they may continue to behave as invalids or constantly worry about having another heart attack.

Many individuals with the disorder do not realise that they have a mental health disorder, and they are convinced that they have physical symptoms requiring medical attention.

Consequently, they typically continue to pressure medical professionals for additional or repeated tests and treatments even after a thorough evaluation has detected nothing or nothing seriously wrong.

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