Somatic symptom disorder

Somatic symptom disorder
Other namesSomatoform disorder, somatization disorder
SpecialtyPsychiatry, psychology
SymptomsMaladaptive thoughts, feelings, and behaviors in response to chronic physical symptoms[1]
ComplicationsReduced functioning, unemployment, financial stress, interpersonal difficulties
Usual onsetChildhood[2]
DurationAt least six months[3]
CausesHeightened awareness of bodily sensations and the tendency to misinterpret bodily sensations[4]
Risk factorsChildhood neglect and abuse, chaotic lifestyle, history of substance and alcohol abuse, psychosocial and biopsychosocial stressors[5]
Diagnostic methodPsychiatric assessment.[2]
Differential diagnosisAdjustment disorder, body dysmorphic disorder, obsessive–compulsive disorder, hypochondriasis[2]
TreatmentCognitive behavioral therapy,[6] medication, interpersonal psychotherapy[7]
MedicationAntidepressants (selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors)[6]
PrognosisOften chronic, but can be managed with the proper treatment[2]
FrequencyAbout 13–23% of the general population[8]

Somatic symptom disorder, also known as somatoform disorder or somatization disorder, is a mental disorder of chronic somatization. One or more chronic physical symptoms coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to said symptoms. The symptoms themselves are not deliberately produced or feigned (as they are in malingering and factitious disorders), and their underlying etiology—whether organic, psychogenic or unexplained—is irrelevant to the diagnosis.[1]

Manifestations of somatic symptom disorder are variable; symptoms can be widespread, specific, and often fluctuate. Somatic symptom disorder corresponds to how an individual views and reacts to symptoms rather than the symptoms themselves, and it can develop in the setting of existing chronic illness or newly onset conditions.[9]

Several studies have found a high frequency of comorbidity with major depressive disorder, generalized anxiety disorder, and phobias.[10] Somatic symptom disorder is frequently associated with functional pain syndromes, such as fibromyalgia and irritable bowel syndrome (IBS).[11] Somatic symptom disorder typically leads to poor overall functioning, interpersonal issues, unemployment or problems at work, and financial strain as a result of frequent healthcare visits.[9]

The etiology of somatic symptom disorder is unknown. Symptoms may result from a heightened awareness of specific physical sensations alongside health anxiety.[2] There is some controversy surrounding the diagnosis, since symptom perception and response are inherently subjective, and may depend on the clinician's interpretation.[12] Additionally, people with known physical illnesses can sometimes be misdiagnosed with it.[13]

  1. ^ a b Cite error: The named reference merck was invoked but never defined (see the help page).
  2. ^ a b c d e Cite error: The named reference StatPearls was invoked but never defined (see the help page).
  3. ^ Dimsdale JE, Levenson JL, Barsky III AJ, Creed F, Frasure-Smith N, Irwin MR, et al. (2013). "Somatic Symptom Disorders". Diagnostic and Statistical Manual of Mental Disorders (5 ed.). Washington DC: American Psychiatric Association. pp. 354–372. ISBN 978-0-89042-555-8.
  4. ^ Cite error: The named reference afp was invoked but never defined (see the help page).
  5. ^ Cite error: The named reference personality was invoked but never defined (see the help page).
  6. ^ a b Somashekar B, Jainer A, Wuntakal B (February 2013). "Psychopharmacotherapy of somatic symptoms disorders". International Review of Psychiatry. 25 (1): 107–115. doi:10.3109/09540261.2012.729758. PMID 23383672. S2CID 25646632.
  7. ^ Cite error: The named reference PIT was invoked but never defined (see the help page).
  8. ^ Sauer KS, Witthöft M, Rief W (November 2023). "Somatic Symptom Disorder and Health Anxiety: Assessment and Management". Neurologic Clinics. 41 (4). Elsevier BV: 745–758. doi:10.1016/j.ncl.2023.02.009. PMID 37775202. S2CID 258266448.
  9. ^ a b Cite error: The named reference mayo was invoked but never defined (see the help page).
  10. ^ Brown FW, Golding JM, Smith GR (July 1990). "Psychiatric comorbidity in primary care somatization disorder". Psychosomatic Medicine. 52 (4): 445–451. doi:10.1097/00006842-199007000-00006. PMID 2399295. S2CID 30954374.
  11. ^ Häuser W, Bialas P, Welsch K, Wolfe F (June 2015). "Construct validity and clinical utility of current research criteria of DSM-5 somatic symptom disorder diagnosis in patients with fibromyalgia syndrome". Journal of Psychosomatic Research. 78 (6): 546–552. doi:10.1016/j.jpsychores.2015.03.151. PMID 25864805.
  12. ^ Kline CL, Shamshair S, Kullgren KA, Leber SM, Malas N (2023-01-01). "A Review of the Impact of Sociodemographic Factors on the Assessment and Management of Pediatric Somatic Symptom and Related Disorders". Journal of the Academy of Consultation-Liaison Psychiatry. 64 (1): 58–64. doi:10.1016/j.jaclp.2022.10.266. PMID 36328180.
  13. ^ Cite error: The named reference Frances_2013 was invoked but never defined (see the help page).
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