Somatic symptom disorders

Somatic Symptom Disorders (SSD) are a group of mental disorders characterized by significant focus on physical symptoms, such as pain or fatigue, that cause major emotional distress and problems functioning. Individuals with these disorders often have excessive thoughts, feelings, or behaviors related to their physical symptoms, which cannot be fully explained by a general medical condition or another mental disorder. The diagnosis and management of somatic symptom disorders require a comprehensive approach that includes both medical and psychological interventions.

Definition and Symptoms

Somatic symptom disorders are defined by the presence of one or more chronic physical symptoms accompanied by excessive and disproportionate thoughts, feelings, and behaviors related to these symptoms. The key features include:

• High level of health-related anxiety
• Excessive time and energy devoted to these symptoms or health concerns
• Persistent thoughts about the seriousness of one's symptoms

Despite thorough medical evaluation, the symptoms cannot be fully explained by a medical condition, substance use, or another mental disorder. It's important to note that the physical symptoms are not intentionally produced or feigned (as in Factitious Disorder or Malingering).

Classification

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorizes somatic symptom disorders into several types, including:

• Somatic Symptom Disorder: Characterized by one or more chronic physical symptoms.
• Illness Anxiety Disorder: Previously known as hypochondriasis, where the concern is not with the symptoms themselves but with the idea of having a serious disease.
• Conversion Disorder: Involves neurological symptoms incompatible with medical conditions, such as paralysis or seizures.
• Psychological Factors Affecting Other Medical Conditions: This is diagnosed when psychological or behavioral factors adversely affect a medical condition.

Causes and Risk Factors

The exact cause of somatic symptom disorders is unknown, but a combination of genetic, biological, and environmental factors is believed to play a role. Risk factors may include:

• Genetic predisposition
• Low pain threshold
• History of trauma or significant stress
• Personality traits (e.g., neuroticism)
• Previous negative medical experiences

Diagnosis

Diagnosis involves a thorough medical history, physical examination, and sometimes, diagnostic tests to rule out other possible causes. The criteria outlined in the DSM-5 are used to diagnose SSD. It's crucial for the diagnosis to be made carefully to avoid overlooking a possible underlying medical condition.

Treatment

Treatment of somatic symptom disorders often involves a multidisciplinary approach, including:

• Psychotherapy: Cognitive-behavioral therapy (CBT) is the most common form of psychotherapy used. It helps patients understand and change their thoughts and behaviors related to their symptoms.
• Medication: Antidepressants may be used to treat underlying depression or anxiety.
• Pain management: For those with chronic pain, pain management techniques, including physical therapy, may be beneficial.
• Patient education: Educating patients about the disorder can help reduce anxiety and improve coping strategies.

Prognosis

The prognosis for individuals with somatic symptom disorders varies. Some individuals may experience significant improvement with treatment, while others may continue to have chronic symptoms. Early diagnosis and treatment can improve outcomes.

See Also

• Anxiety Disorders
• Depression
• Pain Management
• Cognitive Behavioral Therapy