DSM- Somatic Symptom and Related Disorders

What is the high-yield picture of Somatic Symptom Disorder?

One or more distressing somatic symptoms plus excessive thoughts, anxiety, or time/energy devoted to them.

Timeline/onset: Typically 6+ months

Spectrum/severity: Yes: persistent/severity considerations

Important note: Symptoms may be medically explained or unexplained.

What timeframe, age, or number is most important for Somatic Symptom Disorder?

Typically 6+ months

How do you differentiate Somatic Symptom Disorder on an exam vignette?

Key is disproportionate response, not whether symptoms are medically explained.

What is the high-yield picture of Illness Anxiety Disorder?

Preoccupation with having/acquiring serious illness with minimal or no somatic symptoms and high anxiety/checking or avoidance.

Timeline/onset: 6+ months; feared illness may change

Spectrum/severity: No

Important note: Care-seeking or care-avoidant type.

What timeframe, age, or number is most important for Illness Anxiety Disorder?

6+ months; feared illness may change

How do you differentiate Illness Anxiety Disorder on an exam vignette?

Vs. somatic symptom disorder: illness anxiety has absent/mild symptoms; SSD has prominent distressing symptoms.

What is the high-yield picture of Conversion Disorder?

Neurological-type symptoms incompatible with recognized neurological/medical conditions.

Timeline/onset: No fixed minimum

Spectrum/severity: No

Important note: Specify weakness, movement, swallowing, speech, attacks, anesthesia, sensory symptoms.

What timeframe, age, or number is most important for Conversion Disorder?

No fixed minimum

How do you differentiate Conversion Disorder on an exam vignette?

Symptoms are not intentionally produced; distinguish from factitious disorder and malingering.

What is the high-yield picture of Factitious Disorder?

Falsification or induction of symptoms with deceptive presentation as ill, without obvious external reward.

Timeline/onset: No fixed minimum

Spectrum/severity: No

Important note: Imposed on self or another.

What timeframe, age, or number is most important for Factitious Disorder?

No fixed minimum

How do you differentiate Factitious Disorder on an exam vignette?

Vs. malingering: factitious motivation is sick-role; malingering seeks external gain.