Somatic symptom disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]

Overview

Differential Diagnosis

Epidemiology and Demographics

Prevalence

The prevalence of somatic symptom disorder is 5,000 to 7,000 per 100,000 (5-7%) of the overall population.[1]

Risk Factors

Natural History, Complications and Prognosis

Poor prognostic factors include:

  • Depression
  • Anxiety
  • Persistent depressive disorder (dysthymia)
  • Panic disorder
  • Social stress
  • Illness benefits
  • Cognitive factors that affect clinical course include sensitization to pain, heightened attention to bodily sensations, and attribution of bodily symptoms to a possible medical[1]

Diagnostic Criteria

DSM-V Diagnostic Criteria for Somatic Symptom Disorder[1]

A. One or more somatic symptoms that are distressing or result in significant disruption of daily life.

AND

B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:

  1. Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
  2. Persistently high level of anxiety about health or symptoms.
  3. Excessive time and energy devoted to these symptoms or health concerns.

AND

C. Although anyone somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).

Specify if:

With predominant pain (previously pain disorder): This specifier is for individuals whose somatic symptoms predominantly involve pain.

Specify if:

Persistent: A persistent course is characterized by severe symptoms, marked impairment, and long duration (more than 6 months).

Specify current severity:

Mild: Only one of the symptoms specified in Criterion B is fulfilled.
Moderate: Two or more of the symptoms specified in Criterion B are fulfilled.
Severe: Two or more of the symptoms specified in Criterion B are fulfilled, plus there are multiple somatic complaints (or one very severe somatic symptom).

References

  1. 1.0 1.1 1.2 1.3 1.4 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.

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