Somatic Symptom Disorder

Overview

• Somatic symptom disorders = excessive or maladaptive response to physical symptoms or health concerns
• Soma = Body
  • Preoccupation with health or symptoms
  • Physical complaints
  • Usually no identifiable medical condition
• First identified by French doctor who noticed patients coming to him with numerous complaints with no medical basis
• Formerly called Briquet’s syndrome
• Presence of one or more somatic symptoms
  • Symptom is often medically unexplained
• Excessive thoughts, feelings, and behaviors related to the symptoms
  • (e.g., excessive thoughts about seriousness of the symptom, frequent complaints and requests for help, health-related anxiety, excessive research)
• Substantial impairment in social or occupational functioning

DSM-5 Criteria

• A. One or more somatic symptoms that are distressing and/or result in significant disruption of daily life.
• B. Excessive thoughts, feelings, and 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. High level of health-related anxiety.
  • 3. Excessive time and energy devoted to these symptoms or health concerns.
• C. Although any one 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 complaints predominantly involve pain.
• Specify current severity:
  • Mild: Only one of the symptoms 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).

Statistics

• Relatively rare condition
• Onset usually in adolescence
• More likely to affect unmarried, low SES women
• Runs a chronic course
• Research to date is limited due to recent redefinition of the disorder in DSM-5

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