Somatic symptom and related disorders
Somatic Symptom Disorder
Somatic symptom disorder involves one or more physical symptoms that cause significant distress or disruption, together with persistent disproportionate thoughts, anxiety or time and energy focused on them.
Symptoms are real
Physical symptoms do not need to be medically unexplained. A diagnosed medical condition may be present or absent; the diagnosis concerns the intensity and persistence of the response and its functional impact, never whether the person is pretending.
Pain, fatigue, gastrointestinal problems or other symptoms may be accompanied by catastrophic interpretations, repeated body checking, reassurance seeking and increasing restriction of ordinary activities.
Assessment
- At least one physical symptom causes significant distress or disrupts daily life.
- There are disproportionate persistent thoughts, high health anxiety or excessive time and energy devoted to symptoms or health.
- The overall symptomatic state usually lasts more than six months, although individual symptoms may change. Medical illness does not rule the diagnosis in or out.
Coordinated treatment
One coordinating clinician can arrange planned reviews, objective reassessment and avoidance of unnecessary procedures. CBT may reduce catastrophic interpretation, excessive monitoring and avoidance.
Gradual return to movement, work and social activity is planned around the real physical condition and personal goals. Depression, anxiety, pain and medical disease are treated in parallel rather than dismissed.
When to seek help
Seek assessment when symptoms or related worry occupy much of the day and repeatedly drive appointments or avoidance. A new or substantially different symptom, bleeding, fainting, severe pain, fever, unexplained weight loss or a neurological sign needs fresh medical assessment.