Materiały źródłowe

• #1 Somatic Symptom Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532253/

  According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), somatic symptom disorder (SSD) involves one or more physical symptoms accompanied by an excessive amount of time, energy, emotion, and/or behavior related to the symptom that results in significant distress and/or dysfunction. […] The DSM-5 also removed somatization disorder, undifferentiated somatoform disorder, hypochondriasis, and pain disorder. […] Somatic symptom disorder (SSD) is a recently defined diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). […] The two major changes to the DSM-IV criteria included eliminating the requirement that somatic symptoms be organically unexplained and adding the requirement that certain psychobehavioral features have to be present to justify the diagnosis.

• #2 Somatic Symptom Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0101/p49.html

  With the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., the diagnostic category previously known as somatoform disorders is now called somatic symptom and related disorders. […] The main feature of this disorder is a patient’s concern with physical symptoms that he or she attributes to a nonpsychiatric disease. […] Screening instruments are useful in determining the presence of somatic symptom disorder. […] Somatic symptom disorder presents a problem for both the physician and patient because it puts patients at risk of unnecessary testing and treatment. […] The main feature of these disorders is a concern with physical symptoms that are attributed to a nonpsychiatric disease. […] This concern can manifest as one or more somatic symptoms that result in excessive thoughts, feelings, or behaviors related to those symptoms and that are distressing or result in significant disruption of daily life.

• #3 Somatic symptom disorder: Epidemiology, clinical features, and course of illness – UpToDate

  https://www.uptodate.com/contents/somatic-symptom-disorder-epidemiology-clinical-features-and-course-of-illness

  Somatic symptom disorder is characterized by one or more somatic symptoms that are accompanied by excessive thoughts, feelings, and/or behaviors related to the symptoms; the symptoms may or may not be explained by a recognized general medical condition. In addition, the somatic symptoms cause significant distress and/or dysfunction. […] The diagnosis of somatic symptom disorder was introduced in 2013. The disorder consolidates and supplants diagnoses that are no longer formally recognized, including somatization disorder, undifferentiated somatoform disorder, hypochondriasis, and pain disorder; most of the patients who previously received these diagnoses are now diagnosed in the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition, Text Revision (DSM-5-TR) with somatic symptom disorder.

• #4 DSM 5 Somatic Symptom and Related Disorders | Working Fit

  http://www.workingfit.co.uk/medical-evidence/unexplained-and-exaggerated-symptoms/dsm-5-somatic-symptom-and-related-disorders

  The latest edition of DSM 5 has moved away from the need to have no medical explanation in order to make the diagnosis of ‘medically unexplained symptoms’ and gain access to appropriate treatment. The emphasis now is on symptoms that are substantially more severe than expected in association with distress and impairment. The diagnosis includes conditions with no medical explanation and conditions where there is some underlying pathology but an exaggerated response. […] The major diagnosis in this diagnostic class, Somatic Symptom Disorder, emphasises diagnosis made on the basis of positive symptoms and signs (distressing somatic symptoms plus abnormal thoughts, feelings, and behaviours in response to these symptoms) rather than the absence of a medical explanation for somatic symptoms. A distinctive characteristic of many individuals with somatic symptom disorders is not the somatic symptoms per se, but instead the way they present and interpret them.

• #5 Somatic symptom disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/somatic-symptom-disorder/diagnosis-treatment/drc-20377781

  To determine a diagnosis, you’ll likely have a physical exam and any tests your doctor recommends. Your doctor or other health care provider can help determine if you have any health conditions that need treatment. […] The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, emphasizes these points in the diagnosis of somatic symptom disorder: You have one or more somatic symptoms for example, pain or fatigue that are distressing or cause problems in your daily life. You have excessive and persistent thoughts about the seriousness of your symptoms, you have a persistently high level of anxiety about your health or symptoms, or you devote too much time and energy to your symptoms or health concerns. You continue to have symptoms that concern you, typically for more than six months, even though the symptoms may vary.

• #6 Somatic Symptom Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532253/

  Three requirements fulfill the diagnostic criteria for somatic syndrome disorders (SSDs) according to the American Psychiatric Association’s 2013 DSM-5: Somatic symptom(s) that cause significant distress or disruption in daily living; One or more thoughts, feelings, and/or behaviors that are related to the somatic symptom(s) which are persistent, excessive, associated with a high level of anxiety, and results in the devotion of excessive time and energy; Symptoms lasting for more than 6 months. […] The primary objective is to help the patient cope with physical symptoms, including health anxiety and maladaptive behaviors, as opposed to eliminating the symptoms. […] The primary care provider should schedule regular visits to reinforce that symptoms are not suggestive of a life-threatening or disabling medical condition. […] Diagnostic procedures and invasive surgical treatment are not recommended. […] The outlook for patients with somatic syndromes is guarded.

• #7 Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis | Psychological Medicine | Cambridge Core

  https://www.cambridge.org/core/journals/psychological-medicine/article/somatic-symptom-disorder-a-scoping-review-on-the-empirical-evidence-of-a-new-diagnosis/25B7921C514E9B42280B6A7376289729

  In 2013, the American Psychiatric Association (APA) introduced somatic symptom disorder (SSD) as a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013). […] The DSM-5 diagnosis not only received a new name; its diagnostic criteria also differ radically from somatization disorder which it replaced: Following scientific evidence of over two decades, positive psychological criteria were formulated, i.e. excessive health concerns, and exclusion of potentially underlying medical disorders was no longer required. […] There are three diagnostic criteria: The A-criterion requires one or more distressing or disabling somatic symptoms. The B-criterion requires disproportionate and persistent thoughts about the seriousness of one’s symptoms (cognitive dimension), high levels of anxiety about health or symptoms (affective dimension), or excessive energy or time devoted to these symptoms or health concerns (behavioral dimension). The C-criterion specifies that somatic symptoms should persist for over 6 months.

• #8 The Evaluation and Treatment of Somatic Symptom Disorder in Primary Care Practices

  https://www.psychiatrist.com/pcc/evaluation-treatment-somatic-symptom-disorder-primary-care-practices/

  SSD as a diagnosis was introduced in 2013 with the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). SSD is characterized by intense psychological distress (thoughts, feelings, and behaviors) related to physical symptoms (bodily distress) that lasts for more than 6 months. SSD has replaced the DSM-IV diagnosis of somatization disorder, removing the criterion of medically unexplained symptoms. The core feature of this newly defined disorder is the degree of the patients psychological reaction to the symptoms, and the impact of that reaction on their ability to function, rather than on the presence or absence of a medical condition to explain the patients symptoms. The diagnostic criteria for SSD are straightforward compared to those for somatization disorder, which require a certain number of medically unexplained symptoms spread across several organ systems. This new conception of the illness as focusing on the psychological reaction to the symptoms rather than the cause of the symptoms is intended to reduce the stigma many patients have experienced with the diagnosis of somatization disorder and the commonly held interpretation that this means its all in your head. With a diagnosis of SSD, treatment will include techniques to address the thoughts, feelings, and behaviors of the patient in response to the somatic symptoms, with the goal of enabling the patient to engage in meaningful life activities despite having these sensations.

• #9 Somatic symptom disorder: Assessment and diagnosis – UpToDate

  https://www.uptodate.com/contents/somatic-symptom-disorder-assessment-and-diagnosis

  Somatic symptom disorder is characterized by one or more somatic symptoms that are accompanied by excessive thoughts, feelings, and/or behaviors related to the somatic symptoms. In addition, the symptoms cause significant distress and/or dysfunction. The somatic symptoms may or may not be explained by a recognized medical condition. […] This topic reviews the assessment, diagnosis, and differential diagnosis of somatic symptom disorder. […] Somatic symptom disorder is usually diagnosed in general medical settings based upon a history, physical and mental status examination, and laboratory tests. […] We recommend that somatic symptom disorder be diagnosed according to the criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition, Text Revision (DSM-5-TR). The diagnosis requires each of the following: One or more somatic symptoms that cause distress or psychosocial impairment. Excessive thoughts, feelings, or behaviors associated with the somatic symptoms, as demonstrated by one or more of the following: Persistent thoughts about the seriousness of the symptoms; Persistent, severe anxiety about the symptoms or one’s general health; The time and energy devoted to the symptoms or health concerns is excessive. Although the specific somatic symptom(s) may change, the disorder is persistent (usually more than six months).

• #10 Psychiatry.org – Somatic Symptom Disorder

  https://www.psychiatry.org/patients-families/somatic-symptom-disorder

  Somatic symptom disorder is diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms. The physical symptoms may or may not be associated with a diagnosed medical condition, but the person is experiencing symptoms and believes they are sick (that is, not faking the illness). […] A person is not diagnosed with somatic symptom disorder solely because a medical cause cant be identified for a physical symptom. The emphasis is on the extent to which the thoughts, feelings and behaviors related to the illness are excessive or out of proportion.

• #11 Somatic Symptom Disorder: Causes, Diagnosis, Risks, and More

  https://www.healthline.com/health/somatic-symptom-disorder

  Before diagnosing you with somatic symptom disorder, your doctor will start by giving you a thorough physical examination to check for any signs of a physical illness. […] If they dont find any evidence of a medical condition, theyll likely refer you to a mental health professional, who will start by asking questions about your: […] Youll likely be diagnosed with somatic symptom disorder if you: […] experience one or more physical symptoms that cause distress or interfere with your everyday activities […] have excessive or endless thoughts about how serious your symptoms are, causing you to give too much time and energy to evaluating your health […] continue to experience symptoms for six months or more, even if these symptoms change over time.

• #12 Somatic symptom disorder: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000955.htm

  Somatic symptom disorder (SSD) occurs when a person feels extreme, exaggerated anxiety about physical symptoms. […] A person with SSD is not faking their symptoms. […] You will have a complete physical exam. Your provider may do certain tests to find any physical causes of your symptoms. […] Your provider may refer you to a mental health provider. The mental health provider may do further testing. […] The goal of treatment is to control your symptoms and help you function in life. […] You should not be told that your symptoms are imaginary or all in your head. Your provider should work with you to manage both physical and emotional symptoms. […] SSD is a long-term (chronic) condition. Working with your providers and following your treatment plan is important for managing this disorder. […] Counseling may help people who are prone to SSD learn other ways of dealing with stress. This may help reduce the intensity of symptoms.

• #13 Functional neurological and somatic symptom disorders – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/989

  Functional neurological disorder (previously termed conversion disorder) and somatic symptom disorder are both characterised by somatic symptoms associated with significant distress or impairment. […] Functional neurological disorder can be diagnosed on the basis of positive 'rule in’ features on neurological examination – it is no longer considered a diagnosis of exclusion. […] Somatic symptom disorder is characterised by one or more somatic symptoms that are distressing or result in significant disruption of daily life. To meet DSM-5-TR criteria, these patients must have excessive thoughts, feelings, or behaviours related to the somatic symptoms or associated health concerns as manifested by at least one of the following: disproportionate and persistent thoughts about the seriousness of ones symptoms; persistently high levels of anxiety about health or symptoms; excessive time or energy devoted to these symptoms or health concerns. Importantly, even if any one somatic symptom is not continuously present, the state of being symptomatic is persistent (typically more than 6 months).

• #14 Psychiatry.org – What is Somatic Symptom Disorder?

  https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder

  Somatic symptom disorder is diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms. The physical symptoms may or may not be associated with a diagnosed medical condition, but the person is experiencing symptoms and believes they are sick (that is, not faking the illness). […] A person is not diagnosed with somatic symptom disorder solely because a medical cause cant be identified for a physical symptom. The emphasis is on the extent to which the thoughts, feelings and behaviors related to the illness are excessive or out of proportion. […] A diagnosis of somatic symptom disorder requires the person experiencing one or more physical symptoms that are distressing or cause disruption in daily life. Excessive thoughts, feelings or behaviors related to the physical symptoms or health concerns with at least one of the following: ongoing thoughts that are out of proportion with the seriousness of symptoms, ongoing high level of anxiety about health or symptoms, excessive time and energy spent on the symptoms or health concerns. At least one symptom is constantly present, although there may be different symptoms and symptoms may come and go.

• #15 Somatic Symptom Disorder – PsychDB

  https://www.psychdb.com/somatic/dsm-5/somatic-symptom

  Somatic symptom disorder is a mental disorder characterized by multiple, current, somatic symptoms that are distressing or result in significant disruption of daily life. […] The diagnoses of somatic symptom disorder and a concurrent medical illness are not mutually exclusive, and these frequently occur together. […] Somatic symptom disorder is a new diagnosis in the DSM-5. […] Individuals previously diagnosed with somatisation disorder, hypochondriasis, pain disorder, and/or undifferentiated somatoform disorder are typically subsumed under this new diagnosis. […] The presence of somatic symptoms of unclear etiology is not in itself sufficient to make the diagnosis of somatic symptom disorder. […] Conversely, the presence of somatic symptoms of an established medical disorder (e.g. – diabetes or heart disease) does not exclude the diagnosis of somatic symptom disorder if the criteria are otherwise met.

• #16 Somatic Symptom Disorders Workup: Screening Tests, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/294908-workup

  The PHQ-15, WI-7, and SAIB are useful screening instruments to detect persons at risk for somatic symptom disorder, and a combination of these three instruments slightly improves diagnostic accuracy. Their use in routine care will lead to improved detection rates for somatic symptom disorder. […] The PHQ-15, WI-7, and SAIB are useful screening instruments for detecting somatic symptom disorder as described in the DSM-5. […] The SSS-8 is an abbreviated PHQ-15 that has been demonstrated to be a reliable and valid self-report measure for somatic symptom burden. […] Psychological testing – Minnesota Multiphasic Personality Inventory (MMPI) may provide insight into the likelihood of a somatic symptom disorder. (Negative MMPI studies should encourage further pursuit of a medical cause for the symptoms.) […] Imaging studies are not routinely used in diagnosing the somatic symptom disorders. However, functional MRI may be of use in the diagnosis of some conditions such as unexplained visual loss. […] Avoid invasive diagnostic procedures and aggressive surgical assessment.

• #17

  https://journals.lww.com/10.1097/PSY.0000000000000530

  The new DSM-5 somatic symptom disorder was introduced to improve the diagnosis of persons experiencing what used to be called somatoform disorders. […] This study investigates the diagnostic accuracy of three self-report questionnaires that measure somatic complaints (15 item Patient Health Questionnaire [PHQ-15]) and psychological features (7-item Whiteley Index [WI-7]; Scale for Assessing Illness Behavior [SAIB]), in detecting somatic symptom disorder. […] Individual and combined diagnostic accuracy of the PHQ-15, WI-7, and SAIB in detecting somatic symptom disorder was evaluated using the area under the curve (AUC) of a receiver operating characteristic. […] Diagnostic accuracy was adequate to good for each individual questionnaire (PHQ-15: AUC = 0.79, p .001, 95% confidence interval [CI] = 0.730.85; WI-7: AUC = 0.76, p .001, 95% CI = 0.690.83; SAIB: AUC = 0.77, p .001, 95% CI = 0.710.83).

• #18 The Evaluation and Treatment of Somatic Symptom Disorder in Primary Care Practices

  https://www.psychiatrist.com/pcc/evaluation-treatment-somatic-symptom-disorder-primary-care-practices/

  Experts have noted that for patients with SSD, anxiety is the driving force underlying the disproportionate reaction to their symptoms. Anxiety in the context of SSD can manifest as rumination, repetitive checking behaviors to manage the distress, and concerns about the implications of their bodily sensations. We must distinguish whether the patient is expressing a reaction to physical symptoms or having excessive concerns about potential physical symptoms that are not evident. The latter case would be better attributed to IAD. If the patient is focused on the potential for irrational consequences of the physical symptoms, then repeated requests for testing may be like the compulsions found in obsessive-compulsive disorder (OCD). […] A patients preoccupation with their somatic symptoms will alert the clinician to a possible diagnosis of SSD, keeping in mind that SSD is not a diagnosis of exclusion and can co-occur with other medical diagnoses. When a diagnosis of SSD is suspected, it is especially important to inquire about substance use, trauma, major life events, psychosocial circumstances, and life stressors, in addition to the standard psychiatric and social history. The life context in which their symptoms first appeared should also be documented. The Somatic Symptom Disorder-1219 asks about thoughts, feelings, and behaviors associated with the somatic symptom(s) (criterion B in the DSM-5) and is a useful screening tool for SSD.

• #19

  https://journals.lww.com/10.1097/PSY.0000000000000530

  Combining the PHQ-15 and the WI-7 slightly improved diagnostic accuracy (AUC = 0.82, p .001, 95% CI = 0.770.88), as did the combination of all three questionnaires (AUC = 0.85, p .001, 95% CI = 0.790.90). […] The PHQ-15, WI-7, and SAIB are useful screening instruments to detect persons at risk for somatic symptom disorder, and a combination of these three instruments slightly improves diagnostic accuracy.

• #20 Somatic Symptom Disorders Workup: Screening Tests, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/294908-workup

  The PHQ-15, WI-7, and SAIB are useful screening instruments to detect persons at risk for somatic symptom disorder, and a combination of these three instruments slightly improves diagnostic accuracy. Their use in routine care will lead to improved detection rates for somatic symptom disorder. […] The PHQ-15, WI-7, and SAIB are useful screening instruments for detecting somatic symptom disorder as described in the DSM-5. […] The SSS-8 is an abbreviated PHQ-15 that has been demonstrated to be a reliable and valid self-report measure for somatic symptom burden. […] Psychological testing – Minnesota Multiphasic Personality Inventory (MMPI) may provide insight into the likelihood of a somatic symptom disorder. (Negative MMPI studies should encourage further pursuit of a medical cause for the symptoms.) […] Imaging studies are not routinely used in diagnosing the somatic symptom disorders. However, functional MRI may be of use in the diagnosis of some conditions such as unexplained visual loss. […] Avoid invasive diagnostic procedures and aggressive surgical assessment.

• #21 Somatic Symptom Disorder | PM&R KnowledgeNow

  https://now.aapmr.org/somatic-symptom-disorder/

  Conducting a history and interview is essential to diagnose SSD, and patients should fulfill all three diagnostic criteria as mentioned above. […] It is important to differentiate SSD from Illness Anxiety Disorder which consists of a patient who has either no symptoms or very mild symptoms accompanied by significant anxiety and preoccupation on the risk of serious disease. […] There is no physical examination component that is necessary for the diagnosis of SSD. Under the DSM-V criteria, there is no need to rule out medical cause of the symptoms because a diagnosis of SSD can be made with or without a medically explained presentation. […] However, excessive diagnostic testing in the presence of low clinical suspicion in a patient with SSD can be detrimental as it could lead to false positive results, which exacerbate health anxiety and/or could lead to unnecessary treatments/procedures.

• #22 Somatic Symptom and Related Disorders | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/somatic-symptom-and-related-disorders

  In evaluating for SSDs, clinicians will consider whether a child’s symptoms are more frequent and intense than the passing somatic symptoms we all experience, whether the child is having excessive and persistent thoughts and anxiety about existing physical symptoms, and whether the symptoms interfere with daily life, including school, home life and/or peer relationships. […] Medical evaluation is based on symptoms and guided by any previous tests the child or adolescent may have had. Many youth with SSDs have been subjected to a variety of medical tests already, so any medical work-up is balanced with the need to avoid unnecessary and potentially harmful tests and procedures. […] Generally, in children and adolescents with SSDs, the physical examination will find that the symptoms change in different contexts, may not be consistent with any medical findings, or may be more severe than what would be expected from the medical findings. […] If an SSD is suspected, a psychiatric consultation can help the child’s care team understand what may be contributing to the child’s distress and which treatments are likely to be most effective.

• #23 Somatic symptom disorder: Assessment and diagnosis – UpToDate

  https://www.uptodate.com/contents/somatic-symptom-disorder-assessment-and-diagnosis

  Discussing the diagnosis — In discussing the diagnosis of somatic symptom disorder with patients, clinicians should acknowledge the patient’s physical and emotional suffering, emphasize that the somatic symptoms are real, and assure patients that the presence of a psychiatric disorder does not negate the reality of their suffering. […] The differential diagnosis of somatic symptom disorder includes adjustment disorder, body dysmorphic disorder, functional neurological symptom disorder (conversion disorder), delusional disorder (somatic type), depressive disorders, generalized anxiety disorder, illness anxiety disorder, obsessive-compulsive disorder, panic disorder, and psychological factors affecting other medical conditions.

• #24 Somatic Symptom Disorder – PsychDB

  https://www.psychdb.com/somatic/dsm-5/somatic-symptom

  In somatic symptom disorder, the individual’s beliefs that somatic symptoms might reflect serious underlying physical illness are not held with delusional intensity. […] In contrast, in delusional disorder, somatic subtype, the somatic symptom beliefs and behaviour are stronger than those found in somatic symptom disorder.

• #25 Complex Somatic Symptom Disorder (CSSD) | Abnormal Psychology

  https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/complex-somatic-symptom-disorder-cssd/

  2. Predominant health anxiety (previously, hypochondriasis). If patients present solely with health-related anxiety with minimal somatic symptoms, they may be more appropriately diagnosed as having an anxiety disorder. […] For assessing severity of CSSD, metrics are available for rating the presence and severity of somatic symptoms (see for instance PHQ, Kroenke et al, 2002). Scales are also available for assessing severity of the patients misattributions, excessive concerns and preoccupations (see for instance Whiteley inventory, Pilowsky, 1967).

• #26 Differential Diagnosis: Obsessive-Compulsive Disorder vs. Illness Anxiety Disorder vs. Somatic Symptom Disorder – Renewed Freedom Center

  https://renewedfreedomcenter.com/differential-diagnosis-obsessive-compulsive-disorder-vs-illness-anxiety-disorder-vs-somatic-symptom-disorder/

  A person experiencing somatic symptom disorder is typically hypersensitive to normal bodily functions and interprets them as some severe problem they are experiencing. A person with this disorder may interpret their stomach rumbling as a sign of a serious infection or disease rather than them just being hungry or gassy. Additionally, people with this disorder will frequently visit doctors and other medical professionals often complaining of the same physical symptoms, and regular medical interventions do not alleviate the physical symptoms. […] Patients presenting with Somatic Symptom Disorder will look different than the other two disorders as the main fears surround the actual physical sensations they are experiencing and the misinterpretations of said sensations versus the actual illness itself or other obsessive worries. This person may be concerned with a specific illness; however, their main focus will be on the physical sensation (i.e., nausea, shortness of breath) rather than the illness or condition itself (i.e., Flu or COVID-19). Additionally, this person will not be experiencing other unrelated fears and rituals, as discussed above, with OCD.

• #27 Somatic Symptom Disorder – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mental-health-disorders/somatic-symptom-and-related-disorders/somatic-symptom-disorder

  Somatic symptom disorder is characterized by one or more chronic physical symptoms accompanied by significant and out-of-proportion levels of distress, worries, and difficulty in daily functioning related to those symptoms. […] Doctors diagnose the disorder when people continue to be preoccupied and concerned with their symptoms after physical disorders have been ruled out or when their response to an actual physical disorder is unusually intense. […] The main psychiatric diagnostic criterion for diagnosing somatic symptom disorder is the following: People spend a lot of time and energy and frequently have thoughts or anxiety about their physical symptoms, and this causes significant distress and interferes with daily functioning. […] Doctors diagnose somatic symptom disorder when people do the following: Have thoughts that are constant and out of proportion about how serious their symptoms are, Are extremely anxious about their health or the symptoms, Spend an excessive amount of time and energy on the symptoms or health concerns. […] Somatic symptom disorder can be distinguished from similar mental health conditions because a person has persistent symptoms and accompanying excessive thoughts and worries about the symptoms.

• #28 Somatic Symptom Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0101/p49.html

  One of the following criteria must also be present: significant thoughts about the seriousness of the symptoms; a high level of anxiety about the symptoms; or excessive energy spent with regard to symptomatic concern. […] Although somatic symptoms need not be continuously present, they must be persistent (present for more than six months). […] Two specifiers of this condition in the DSM-5 are with predominant pain and persistent. […] These disorders can be mild, moderate, or severe. […] Diagnostic criteria: A. One or more somatic symptoms that are distressing or result in significant disruption of daily life. B. Excessive thoughts, feelings, or 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. Persistently high level of anxiety about health or symptoms. 3. Excessive time and energy devoted to these symptoms or health concerns. C. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).

• #29 Somatic Symptom Disorder | PM&R KnowledgeNow

  https://now.aapmr.org/somatic-symptom-disorder/

  Criterion A: One or more somatic symptoms that are distressing or result in significant disruption of daily life. […] Criterion B: Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following […] Criterion C: Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months). […] The DSM-V states that the following specifications should be made: With Predominant Pain (previously pain disorder): for individuals whose somatic symptoms predominantly involve pain. […] Severity specifications are outlined as: Mild: Only one of the symptoms specified 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).

• #30 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Somatic-Symptom-Disorder.aspx

  With regards to the severity of somatic symptom disorder, severity is defined as when two or more of the psychobehavioral symptoms are fulfilled, and there are multiple somatic complaints; moderate when two or more psychobehavioral symptoms only are fulfilled and mild when only one psychobehavioural symptom is fulfilled. […] Those that suffer from somatic symptom disorder typically present in the primary care setting as opposed to a secondary care physician such as a psychiatrist or other mental health professional. […] The anxiety surrounding their symptoms will persist in instances when it has been evidenced to them that they do not have a serious condition. […] Referral to a psychiatrist is highly recommended when primary healthcare professionals are presented with a patient with somatic syndrome disorder.

• #31 Somatoform Disorders: Symptoms, Types, and Treatment

  https://www.webmd.com/mental-health/somatoform-disorders-symptoms-types-treatment

  Somatic symptom disorder (SSD formerly known as „somatization disorder” or „somatoform disorder”) is a form of mental illness that causes one or more bodily symptoms, including pain. […] Doctors need to perform many tests to rule out other possible causes before diagnosing SSD. […] The diagnosis of SSD can create a lot of stress and frustration for patients. […] A strong doctor-patient relationship is key to getting help with SSD. Seeing a single healthcare provider with experience managing SSD can help cut down on unnecessary tests and treatments.

• #32 Somatic Symptom Disorder: Symptoms, Causes, Treatments

  https://www.webmd.com/mental-health/somatic_symptom_disorder

  Somatic symptom disorder is when you worry about and focus on your physical health to a degree that it impacts your daily life. […] Diagnosing somatic symptom disorder can be very difficult, because it really feels like your symptoms and feelings of distress are caused by a medical illness. Your doctor will give you a physical exam and psychological testing to diagnose the condition. […] If a physical illness is ruled out as the cause of your symptoms, your doctor will do a screening test. […] If your doctor thinks you need to see a specialist, they may suggest you get care from a psychiatrist or psychologist, health care professionals trained to diagnose and treat mental illnesses. These doctors can confirm the diagnosis and help you get the care you need to relieve your symptoms. […] A main goal of somatic symptom disorder treatment is to help patients live and function as normally as possible, even if they continue to have symptoms. Treatment also aims to alter the thinking and behavior that lead to the symptoms.

• #33 Psychiatry.org – What is Somatic Symptom Disorder?

  https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder

  People with somatic symptom disorder typically go to a primary care physician rather than a psychiatrist or other mental health professional. Individuals with somatic symptom disorder may experience difficulty accepting that their concerns about their symptoms are excessive. They may continue to be fearful and worried even when they are shown evidence that they do not have a serious condition. Some people have only pain as their dominant symptom. Somatic symptom disorder usually begins by age 30.

• #34 Somatic symptom disorder: Assessment and diagnosis – UpToDate

  https://www.uptodate.com/contents/somatic-symptom-disorder-assessment-and-diagnosis

  Discussing the diagnosis — In discussing the diagnosis of somatic symptom disorder with patients, clinicians should acknowledge the patient’s physical and emotional suffering, emphasize that the somatic symptoms are real, and assure patients that the presence of a psychiatric disorder does not negate the reality of their suffering. […] The differential diagnosis of somatic symptom disorder includes adjustment disorder, body dysmorphic disorder, functional neurological symptom disorder (conversion disorder), delusional disorder (somatic type), depressive disorders, generalized anxiety disorder, illness anxiety disorder, obsessive-compulsive disorder, panic disorder, and psychological factors affecting other medical conditions.

• #35 The often missed diagnosis of somatic symptom disorder in sexual dysfunction: recognizing symptoms and management tips for clinicians | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-024-00994-4

  Undiagnosed Somatic Symptom Disorder (SSD) often complicates the management of patients seeking treatment for sexual dysfunctions. […] Many clinicians, including physicians and sexologists, might be unfamiliar with SSD, which can prevent them from identifying the condition and providing effective treatment. […] As defined by the DSM-5 and ICD-11, SSD is characterized by the presence of one or more physical symptoms accompanied by excessive thoughts, emotions, and behaviors associated with the symptom, resulting in significant distress. […] The consequences of SSD result in major distress, often elevating the risk of suicidal ideation or attempts. […] Effective interventions require psychiatric management, including cognitive-behavioral therapy and pharmacotherapy.

• #36 Somatic symptom disorder: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000955.htm

  Somatic symptom disorder (SSD) occurs when a person feels extreme, exaggerated anxiety about physical symptoms. […] A person with SSD is not faking their symptoms. […] You will have a complete physical exam. Your provider may do certain tests to find any physical causes of your symptoms. […] Your provider may refer you to a mental health provider. The mental health provider may do further testing. […] The goal of treatment is to control your symptoms and help you function in life. […] You should not be told that your symptoms are imaginary or all in your head. Your provider should work with you to manage both physical and emotional symptoms. […] SSD is a long-term (chronic) condition. Working with your providers and following your treatment plan is important for managing this disorder. […] Counseling may help people who are prone to SSD learn other ways of dealing with stress. This may help reduce the intensity of symptoms.

• #37 Somatic symptom disorder: Assessment and diagnosis – UpToDate

  https://www.uptodate.com/contents/somatic-symptom-disorder-assessment-and-diagnosis

  Discussing the diagnosis — In discussing the diagnosis of somatic symptom disorder with patients, clinicians should acknowledge the patient’s physical and emotional suffering, emphasize that the somatic symptoms are real, and assure patients that the presence of a psychiatric disorder does not negate the reality of their suffering. […] The differential diagnosis of somatic symptom disorder includes adjustment disorder, body dysmorphic disorder, functional neurological symptom disorder (conversion disorder), delusional disorder (somatic type), depressive disorders, generalized anxiety disorder, illness anxiety disorder, obsessive-compulsive disorder, panic disorder, and psychological factors affecting other medical conditions.

• #38 Somatic Symptom Disorder | PM&R KnowledgeNow

  https://now.aapmr.org/somatic-symptom-disorder/

  In 2018, a clinical neuroscience journal published recommendations on the management of SSD based on the best available evidence and clinical expertise. Those recommendations include but are not limited to the following practice principles: Somatic symptoms should be taken seriously even if no well-defined organic pathology is demonstrated. […] Effective communication with the patient is essential and includes reassurance, anticipation of likely outcomes of diagnostic tests, and motivation to actively engage in coping with bodily stress. […] Cognitive Behavioral Therapy has been identified as an effective method of improving functioning and managing somatic complaints. […] Psychopharmacological intervention in the form of SSRIs or SNRIs demonstrated efficacy in improvement of SSD in a study on pharmacological interventions for somatoform disorders in adults.

• #39 Somatic Symptom Disorder: Causes and Symptoms

  https://patient.info/doctor/somatic-symptom-disorder

  A psychological evaluation should also be performed to rule out related disorders: […] Somatisation is often a diagnosis of exclusion; however, it is much more effective to pursue a positive diagnosis of somatisation when the patient presents with typical features: […] The first occasion that the diagnosis is discussed (after the initial investigations have failed to show any organic pathology) is a key moment in the physician-patient relationship. […] Once other causes have been ruled out and a diagnosis of SSD secured, the goal of treatment is to help the person learn to control the symptoms: […] It is sensible to avoid setting unrealistic goals: […] A better goal is to help the patient succeed in coping with the symptoms. Treatment is successful if it keeps the patient out of the hospital. […] Regular appointments should be maintained to review symptoms and the person’s coping mechanisms.

• #40 Somatic Symptom Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/somatic-symptom-disorder

  Somatic symptom disorder may not be diagnosed in older patients because certain symptoms, such as fatigue or pain, are considered part of aging. […] Somatic symptom disorder is distinguished from generalized anxiety disorder, functional neurological symptom disorder, and major depression by the predominance, multiplicity, and persistence of physical symptoms and the accompanying excessive thoughts, feelings, and behaviors.

• #41 Somatic Symptom and Related Disorders | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/somatic-symptom-and-related-disorders

  In evaluating for SSDs, clinicians will consider whether a child’s symptoms are more frequent and intense than the passing somatic symptoms we all experience, whether the child is having excessive and persistent thoughts and anxiety about existing physical symptoms, and whether the symptoms interfere with daily life, including school, home life and/or peer relationships. […] Medical evaluation is based on symptoms and guided by any previous tests the child or adolescent may have had. Many youth with SSDs have been subjected to a variety of medical tests already, so any medical work-up is balanced with the need to avoid unnecessary and potentially harmful tests and procedures. […] Generally, in children and adolescents with SSDs, the physical examination will find that the symptoms change in different contexts, may not be consistent with any medical findings, or may be more severe than what would be expected from the medical findings. […] If an SSD is suspected, a psychiatric consultation can help the child’s care team understand what may be contributing to the child’s distress and which treatments are likely to be most effective.

• #42

  https://link.springer.com/article/10.1007/s10880-024-10005-9

  The DSM-5 included major revisions in the area of somatization disorders. […] Somatic symptom disorder contains three criteria. […] Determining what constitutes excessive relative to their circumstances remains at the clinicians discretion. […] Among fibromyalgia patients, prevalence of comorbid SSD ranges from 13.3% to 40%. […] Individuals with SSD also show poorer prognosis. […] Although these findings may suggest a decrease in validity, it is possible that we are seeing a ceiling effect with a population already high in functional impairment and healthcare utilization. […] There is clinical utility in identifying patients with psychological features and connecting them with treatment, but some evidence suggests an increase in pain as the result of CBT. […] Furthermore, the acceptability of the diagnosis is low for patients and may have resounding real-world consequences. […] The new DSM-5 criteria should be used with caution by providers until questions of validity, reliability, clinical utility and acceptability are resolved.

• #43 The Importance of Early Diagnosis of Somatic Symptom Disorder: A Case Report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10544785/

  Cognitive-behavioral therapy is the treatment of choice for these patients. […] The efficacy of drugs other than antidepressants, a deeper comparison of antidepressants, and longer follow-ups should all be the subject of future studies of the highest caliber. […] Early diagnosis is of the essence in such cases. Not only is it a pillar of primary prevention, but it also helps plan the treatment for such patients. […] Early detection and treatment are essential to preventing, managing, and treating SSDs.

• #44 Somatic Symptom Disorder – Harvard Health

  https://www.health.harvard.edu/a_to_z/somatic-symptom-disorder-a-to-z

  Although there is no way to prevent this disorder, a correct diagnosis of somatic symptom disorder can help the person avoid excessive medical testing. […] People with somatic symptom disorder may find it difficult to accept a referral to a mental health professional or to accept that medical evaluation and treatment cannot relieve the symptoms. […] Ideally, if a primary care physician and mental health professional work together, the person’s physical symptoms can be evaluated while he or she also gets help managing the frustration of not having a clear diagnosis or treatment plan. […] The earlier a person with somatic symptom disorder can be evaluated by a mental health professional, the easier it will be to help the person deal with the consequences of the disorder, such as exposure to unnecessary tests and treatment, or difficulty with relationships and poor productivity at work. […] Medications may provide some relief. Psychotherapy tends to proceed slowly, because the person probably has been living with the disorder for many years before starting treatment.

• #45 Somatic Symptom Disorder – Harvard Health

  https://www.health.harvard.edu/a_to_z/somatic-symptom-disorder-a-to-z

  Although there is no way to prevent this disorder, a correct diagnosis of somatic symptom disorder can help the person avoid excessive medical testing. […] People with somatic symptom disorder may find it difficult to accept a referral to a mental health professional or to accept that medical evaluation and treatment cannot relieve the symptoms. […] Ideally, if a primary care physician and mental health professional work together, the person’s physical symptoms can be evaluated while he or she also gets help managing the frustration of not having a clear diagnosis or treatment plan. […] The earlier a person with somatic symptom disorder can be evaluated by a mental health professional, the easier it will be to help the person deal with the consequences of the disorder, such as exposure to unnecessary tests and treatment, or difficulty with relationships and poor productivity at work. […] Medications may provide some relief. Psychotherapy tends to proceed slowly, because the person probably has been living with the disorder for many years before starting treatment.

• #46

  https://www.rula.com/blog/somatic-symptom-disorder/

  If you answered yes to many of these questions especially numbers 11 and 12 its possible you have somatic symptom disorder. […] Diagnosing a somatic symptom or related disorder is complex. Medical professionals need to first rule out any other health conditions that might be contributing to your physical symptoms. […] Somatic symptom disorder is a legitimate health condition that requires treatment. […] If you disagree with your diagnosis or if you think your symptoms are a sign of another medical condition, not somatic symptom disorder let your healthcare provider know right away. […] Somatic symptom disorder is treatable, and you arent alone.

• #47 Estimated frequency of somatic symptom disorder in general practice: cross-sectional survey with general practitioners | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-04100-0

  Somatic symptom disorder (SSD) is the successor diagnosis of somatoform disorder in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). […] We estimate a frequency of 7.7% of patients in general practice to fulfil the diagnostic criteria of SSD. […] GPs saw the clinical symptoms of SSD fulfilled (A and B criteria) in 21.5% (95% CI: 20.6 to 22.3) of their patients. […] The GPs estimated that 21.5% (95% CI: 20.6 to 22.3) of their patients would show the clinical symptoms of SSD (A and B criteria). […] The new variable, consisting of the case wise product of the estimated proportion of patients with clinical symptoms of SSD (A and B criteria), and the estimated proportion of patients with symptoms persisting for more than 6 months (C criterion), yielded a mean frequency estimate of 7.7% (95% CI: 7.1 to 8.4) of patients in general practice with a diagnosis of full-blown SSD.

• #48 DSM 5 Somatic Symptom and Related Disorders | Working Fit

  http://www.workingfit.co.uk/medical-evidence/unexplained-and-exaggerated-symptoms/dsm-5-somatic-symptom-and-related-disorders

  The diagnostic criteria for Somatic Symptom Disorder noted in DSM 5 are: One or more somatic symptoms that are distressing or result in significant disruption of daily life. Excessive thoughts, feelings, or behaviours related to the somatic symptoms or associated health concerns as manifested by at least one of the following: Disproportionate and persistent thoughts about the seriousness of one’s symptoms. Persistently high level of anxiety about health or symptoms. Excessive time and energy devoted to these symptoms or health concerns. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months). […] The expected prevalence of Somatic Symptom Disorder stated in DSM 5 is higher than that for Somatization Disorder (<1%) but lower than that of Undifferentiated Somatoform Disorder (19%). Both are more common in women. Nevertheless, the term Somatic Symptom Disorder is considered by DSM 5 to be broadly equivalent to ICD10 F45.1 and ICD9 300.82 Undifferentiated Somatoform Disorder, and includes most patients with Hypochondriasis ICD 10 F45.21 and ICD 9 300.7.

• #49 Module 8: Somatic Symptom and Related Disorders – Fundamentals of Psychological Disorders

  https://opentext.wsu.edu/abnormal-psych/chapter/module-8-somatic-symptom-and-related-disorders/

  The prevalence rates for somatic disorders are often difficult to determine; however, overall estimates of somatic symptom disorder are around 4-6%. […] Given that half of psychiatric patients also have an additional medical disorder, 35% have an undiagnosed medical condition, and approximately 20% reported medical problems caused their mental condition, it should not come as a surprise that somatic disorders, in general, have high comorbidity with other psychological disorders (Felker, Yazel, Short, 1996). […] Somatic symptom disorder is also comorbid with PTSD and OCD. […] Treatment for these disorders is often difficult as individuals see their problems as completely medical, and therefore, do not think psychological intervention is necessary (Lahmann, Henningsen, Noll-Hussong, 2010).

• #50 DSM 5 Somatic Symptom and Related Disorders | Working Fit

  http://www.workingfit.co.uk/medical-evidence/unexplained-and-exaggerated-symptoms/dsm-5-somatic-symptom-and-related-disorders

  The diagnostic criteria for Somatic Symptom Disorder noted in DSM 5 are: One or more somatic symptoms that are distressing or result in significant disruption of daily life. Excessive thoughts, feelings, or behaviours related to the somatic symptoms or associated health concerns as manifested by at least one of the following: Disproportionate and persistent thoughts about the seriousness of one’s symptoms. Persistently high level of anxiety about health or symptoms. Excessive time and energy devoted to these symptoms or health concerns. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months). […] The expected prevalence of Somatic Symptom Disorder stated in DSM 5 is higher than that for Somatization Disorder (<1%) but lower than that of Undifferentiated Somatoform Disorder (19%). Both are more common in women. Nevertheless, the term Somatic Symptom Disorder is considered by DSM 5 to be broadly equivalent to ICD10 F45.1 and ICD9 300.82 Undifferentiated Somatoform Disorder, and includes most patients with Hypochondriasis ICD 10 F45.21 and ICD 9 300.7.

• #51 Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis | Psychological Medicine | Cambridge Core

  https://www.cambridge.org/core/journals/psychological-medicine/article/somatic-symptom-disorder-a-scoping-review-on-the-empirical-evidence-of-a-new-diagnosis/25B7921C514E9B42280B6A7376289729

  The predictive validity of SSD’s diagnostic criteria was further demonstrated in psychosomatic inpatients and in patients with fibromyalgia. […] Another study indicated that patients with SSD showed a lower level of functioning and quality of life than healthy controls. […] According to the DSM-5 field trials, SSD was among the most improved and useful criteria sets according to clinicians. […] Other authors stressed the clinical utility of the new concept compared to DSM-IV. […] Results from a qualitative study in general practitioners indicated that the advantages of SSD outweigh its disadvantages; especially the new psychological criteria and no longer making the diagnosis by exclusion of physical disease were regarded as improvements for clinical practice. […] The current lack of studies examining the prevalence of SSD based on criterion-standard interviews is a major research gap, precluding reliable estimates of the prevalence of SSD.

• #52 Somatic symptom disorder: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000955.htm

  Somatic symptom disorder (SSD) occurs when a person feels extreme, exaggerated anxiety about physical symptoms. […] A person with SSD is not faking their symptoms. […] You will have a complete physical exam. Your provider may do certain tests to find any physical causes of your symptoms. […] Your provider may refer you to a mental health provider. The mental health provider may do further testing. […] The goal of treatment is to control your symptoms and help you function in life. […] You should not be told that your symptoms are imaginary or all in your head. Your provider should work with you to manage both physical and emotional symptoms. […] SSD is a long-term (chronic) condition. Working with your providers and following your treatment plan is important for managing this disorder. […] Counseling may help people who are prone to SSD learn other ways of dealing with stress. This may help reduce the intensity of symptoms.

• #53 Somatic Symptom Disorder: Symptoms, Causes, Treatments

  https://www.webmd.com/mental-health/somatic_symptom_disorder

  Treatment for somatic symptom disorder most often includes a combination of options. […] Diagnosing somatic symptom disorder can be very difficult, because it really feels like your symptoms and feelings of distress are caused by a medical illness. Your doctor will give you a physical exam and psychological testing to diagnose the condition. […] If you have somatic symptom disorder, it probably affects many areas of your life. […] This disorder tends to be a chronic (long-term) condition that can last for years. […] If you are diagnosed with somatic symptom disorder, get treated early and stick with the treatment your doctor recommends. […] Seeking mental health treatment is the best way to manage, and sometimes completely get rid of, symptoms.

• #54 Somatic Symptom Disorder – Harvard Health

  https://www.health.harvard.edu/a_to_z/somatic-symptom-disorder-a-to-z

  A person with somatic symptom disorder has one or more „somatic” (physical) symptoms over a long period of time (usually half a year or more). […] There are no laboratory tests to determine whether a person has somatic symptom disorder. The doctor may suspect it when a person has persistent physical complaints that do not respond to usual medical evaluation and treatment. […] In 2013, this diagnosis replaced other disorders that are no longer listed in the diagnostic manual for psychiatry. […] Many people with somatic symptom disorder also have a problem with depression or anxiety, so doctors may consider these diagnoses. If the person is willing, it is helpful to consult with a mental health professional for further evaluation. […] Somatic symptom disorder is a chronic (long-lasting) problem. The disorder usually starts before the age of 25 or 30, although it can begin in adolescence. It can last for many years.

• #55 The Importance of Early Diagnosis of Somatic Symptom Disorder: A Case Report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10544785/

  A person must have at least one distressing somatic symptom and excessive thoughts, feelings, or behaviors related to the somatic symptom or any health issues that are related for SSD to be diagnosed. […] This case differs from the traditional presentation in that the patient did not excessively worry about the illness and did not base their behavior around the disease. […] Therefore, in such conditions, the diagnosis can be missed, as in our case, where it went undiagnosed for 10 years. […] Nevertheless, in this case, strong evidence renders a diagnosis of SSD. […] Somatic symptom disorders typically last for a long time. However, only 10% to 30% of people experience deterioration, while 50% to 75% experience improvement. […] A comprehensive treatment plan tailored to each patient is required.

• #56 Somatic Symptom Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532253/

  Three requirements fulfill the diagnostic criteria for somatic syndrome disorders (SSDs) according to the American Psychiatric Association’s 2013 DSM-5: Somatic symptom(s) that cause significant distress or disruption in daily living; One or more thoughts, feelings, and/or behaviors that are related to the somatic symptom(s) which are persistent, excessive, associated with a high level of anxiety, and results in the devotion of excessive time and energy; Symptoms lasting for more than 6 months. […] The primary objective is to help the patient cope with physical symptoms, including health anxiety and maladaptive behaviors, as opposed to eliminating the symptoms. […] The primary care provider should schedule regular visits to reinforce that symptoms are not suggestive of a life-threatening or disabling medical condition. […] Diagnostic procedures and invasive surgical treatment are not recommended. […] The outlook for patients with somatic syndromes is guarded.

• #57 Somatic Symptom Disorder DSM-5 300.82 (F45.1)

  https://www.theravive.com/therapedia/somatic-symptom-disorder-dsm–5-300.82-(f45.1)

  While psychological disorders often underlie somatic disorders, those with SSD first seek medical assistance from a family physician in the belief they have a physical ailment. […] Two forms of pharmacotherapy are pursued in the treatment of SSD somatic medication targeting the symptoms and the use of psychotropics to target SSD, often used when somatic medication is not successful (Mundt, 2013). […] Those with SSD in childhood often continue to develop similar somatic symptoms in adulthood.

• #58 Somatic Symptom Disorder – Harvard Health

  https://www.health.harvard.edu/a_to_z/somatic-symptom-disorder-a-to-z

  Although there is no way to prevent this disorder, a correct diagnosis of somatic symptom disorder can help the person avoid excessive medical testing. […] People with somatic symptom disorder may find it difficult to accept a referral to a mental health professional or to accept that medical evaluation and treatment cannot relieve the symptoms. […] Ideally, if a primary care physician and mental health professional work together, the person’s physical symptoms can be evaluated while he or she also gets help managing the frustration of not having a clear diagnosis or treatment plan. […] The earlier a person with somatic symptom disorder can be evaluated by a mental health professional, the easier it will be to help the person deal with the consequences of the disorder, such as exposure to unnecessary tests and treatment, or difficulty with relationships and poor productivity at work. […] Medications may provide some relief. Psychotherapy tends to proceed slowly, because the person probably has been living with the disorder for many years before starting treatment.

• #59 Somatic Symptom Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0101/p49.html

  The management of somatic symptom disorders requires a multifaceted approach tailored to the individual patient. […] General treatment tenets for the primary care clinician include scheduling regular, short-interval visits to avoid the need for symptoms to get an appointment; establishing a collaborative, therapeutic alliance with the patient; acknowledging and legitimizing symptoms once the patient has been evaluated for other medical and psychiatric diseases; limiting diagnostic testing; reassuring the patient that serious medical diseases have been ruled out; educating patients about coping with physical symptoms; setting a treatment goal of functional improvement rather than cure; and appropriately referring patients to subspecialists and mental health professionals. […] Proven therapies provided by mental health care professionals include cognitive behavior therapy and mindfulness-based therapy.

• #60 Somatic Symptom Disorder | PM&R KnowledgeNow

  https://now.aapmr.org/somatic-symptom-disorder/

  In 2018, a clinical neuroscience journal published recommendations on the management of SSD based on the best available evidence and clinical expertise. Those recommendations include but are not limited to the following practice principles: Somatic symptoms should be taken seriously even if no well-defined organic pathology is demonstrated. […] Effective communication with the patient is essential and includes reassurance, anticipation of likely outcomes of diagnostic tests, and motivation to actively engage in coping with bodily stress. […] Cognitive Behavioral Therapy has been identified as an effective method of improving functioning and managing somatic complaints. […] Psychopharmacological intervention in the form of SSRIs or SNRIs demonstrated efficacy in improvement of SSD in a study on pharmacological interventions for somatoform disorders in adults.

• #61 Somatic Symptom Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532253/

  Three requirements fulfill the diagnostic criteria for somatic syndrome disorders (SSDs) according to the American Psychiatric Association’s 2013 DSM-5: Somatic symptom(s) that cause significant distress or disruption in daily living; One or more thoughts, feelings, and/or behaviors that are related to the somatic symptom(s) which are persistent, excessive, associated with a high level of anxiety, and results in the devotion of excessive time and energy; Symptoms lasting for more than 6 months. […] The primary objective is to help the patient cope with physical symptoms, including health anxiety and maladaptive behaviors, as opposed to eliminating the symptoms. […] The primary care provider should schedule regular visits to reinforce that symptoms are not suggestive of a life-threatening or disabling medical condition. […] Diagnostic procedures and invasive surgical treatment are not recommended. […] The outlook for patients with somatic syndromes is guarded.

• #62 Somatic Symptom Disorder: Causes and Symptoms

  https://patient.info/doctor/somatic-symptom-disorder

  A psychological evaluation should also be performed to rule out related disorders: […] Somatisation is often a diagnosis of exclusion; however, it is much more effective to pursue a positive diagnosis of somatisation when the patient presents with typical features: […] The first occasion that the diagnosis is discussed (after the initial investigations have failed to show any organic pathology) is a key moment in the physician-patient relationship. […] Once other causes have been ruled out and a diagnosis of SSD secured, the goal of treatment is to help the person learn to control the symptoms: […] It is sensible to avoid setting unrealistic goals: […] A better goal is to help the patient succeed in coping with the symptoms. Treatment is successful if it keeps the patient out of the hospital. […] Regular appointments should be maintained to review symptoms and the person’s coping mechanisms.

• #63 Module 8: Somatic Symptom and Related Disorders – Fundamentals of Psychological Disorders

  https://opentext.wsu.edu/abnormal-psych/chapter/module-8-somatic-symptom-and-related-disorders/

  The prevalence rates for somatic disorders are often difficult to determine; however, overall estimates of somatic symptom disorder are around 4-6%. […] Given that half of psychiatric patients also have an additional medical disorder, 35% have an undiagnosed medical condition, and approximately 20% reported medical problems caused their mental condition, it should not come as a surprise that somatic disorders, in general, have high comorbidity with other psychological disorders (Felker, Yazel, Short, 1996). […] Somatic symptom disorder is also comorbid with PTSD and OCD. […] Treatment for these disorders is often difficult as individuals see their problems as completely medical, and therefore, do not think psychological intervention is necessary (Lahmann, Henningsen, Noll-Hussong, 2010).

• #64 Somatic Symptom And Related Disorders: DSM-5 Diagnostic Codes – Senior Care Psychological Consulting

  https://seniorcarepsychological.com/somatic-symptom-and-related-disorders-dsm-5-diagnostic-codes-2/

  The coexistence or comorbidity between somatic symptoms and mental health symptoms such as depression and anxiety is enormous. […] Treatments for what was previously referred to as hypochondriasis in the DSM-4-TR and now defined as somatic symptom disorder or illness anxiety disorder frequently involves cognitive behavioral therapy, medication and psychoeducation. […] Among the antidepressants, fluoxetine seems to be most helpful especially for symptoms that were formally referred to as hypochondriasis. […] Please see the following pages for specific symptoms and treatment information related to each diagnosis within the category of somatic symptom and related disorders.

• #65 Somatic Symptom Disorder – Harvard Health

  https://www.health.harvard.edu/a_to_z/somatic-symptom-disorder-a-to-z

  A person with somatic symptom disorder has one or more „somatic” (physical) symptoms over a long period of time (usually half a year or more). […] There are no laboratory tests to determine whether a person has somatic symptom disorder. The doctor may suspect it when a person has persistent physical complaints that do not respond to usual medical evaluation and treatment. […] In 2013, this diagnosis replaced other disorders that are no longer listed in the diagnostic manual for psychiatry. […] Many people with somatic symptom disorder also have a problem with depression or anxiety, so doctors may consider these diagnoses. If the person is willing, it is helpful to consult with a mental health professional for further evaluation. […] Somatic symptom disorder is a chronic (long-lasting) problem. The disorder usually starts before the age of 25 or 30, although it can begin in adolescence. It can last for many years.

• #66 Somatic Symptom Disorder – BHC

  https://behavioralhealth-centers.com/dual-diagnosis/somatic-symptom-disorder/

  The biggest indicator of somatic symptom disorder is the excessive reactions they have toward their health concerns (massive distress and negative emotions). […] The signs of possible somatic symptom disorder can be seen through intense worry and distress, even if a medical concern is not addressed. […] Due to the excessive reaction to physical symptoms, a person has risk factors for developing a co-occurring disorder. […] This occurs when a person is struggling with a mental illness (in this case somatic disorder) and drug addiction. In treatment, substance abuse and other mental health disorders are treated simultaneously but separately. […] Treating somatic symptom disorder usually involves a combination of psychotherapy and medication from an experienced mental health professional. It is a mental illness, so much of it will be understanding and dealing with a person’s intense worry over the symptoms.

• #67 The Evaluation and Treatment of Somatic Symptom Disorder in Primary Care Practices

  https://www.psychiatrist.com/pcc/evaluation-treatment-somatic-symptom-disorder-primary-care-practices/

  SSD differs from the past DSM-IV diagnosis of somatization in that it focuses on the disproportionate psychological reaction to the somatic symptoms rather than on the medically unexplained nature of the somatic symptoms. In fact, SSD can co-occur with a medical diagnosis. The diagnosis of SSD creates more room for a therapeutic alliance and the possibility of a treatment plan that helps the patient regain as much function and meaningful activity as possible. As SSD was only defined in 2013, it is important to incorporate SSD diagnosis and treatment into medical school and residency curricula.

• #68 Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis | Psychological Medicine | Cambridge Core

  https://www.cambridge.org/core/journals/psychological-medicine/article/somatic-symptom-disorder-a-scoping-review-on-the-empirical-evidence-of-a-new-diagnosis/25B7921C514E9B42280B6A7376289729

  In 2013, the diagnosis of somatic symptom disorder (SSD) was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This review aims to comprehensively synthesize contemporary evidence related to SSD. […] Eight hundred and eighty-two articles were identified, of which 59 full texts were included for analysis. Empirical evidence supports the reliability, validity, and clinical utility of SSD diagnostic criteria, but the further specification of the psychological SSD B-criteria criteria seems necessary. […] Strengths of the SSD diagnosis are its good reliability, validity, and clinical utility, which substantially improved on its predecessors. SSD characterizes a specific patient population that is significantly impaired both physically and psychologically. However, substantial research gaps exist, e.g., regarding SSD prevalence assessed with criterion standard diagnostic interviews.

• #69 Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis | Psychological Medicine | Cambridge Core

  https://www.cambridge.org/core/journals/psychological-medicine/article/somatic-symptom-disorder-a-scoping-review-on-the-empirical-evidence-of-a-new-diagnosis/25B7921C514E9B42280B6A7376289729

  In the DSM-5 field trials, SSD showed good inter-rater reliability between clinicians. […] One study indicated that SSD and IAD were more reliable diagnoses than the DSM-IV diagnosis of hypochondriasis. […] The majority of studies considered the inclusion of the B-criteria as a positive change in the diagnostic conception. […] However, the choice of the three psychological B-criteria was criticized, and the relevance of the clinical context and the interpretation of these criteria were highlighted for diagnosing SSD and its severity. […] A general population study indicated that the total number of somatic symptoms in the general population was an independent predictor for health status. […] The authors concluded that these findings supported abandoning the diagnostic criterion that somatic complaints must be medically unexplained, as was required with somatoform disorders in DSM-IV and ICD-10.

• #70 Understanding Somatic Symptom Disorder: Diagnosis, Symptoms, and Treatment – Symptom Media

  https://symptommedia.com/understanding-somatic-symptom-disorder-diagnosis-symptoms-and-treatment/

  The Diagnostic and Statistical Manual for Mental Disorders 5, Text Revision (DSM-5-TR) defines somatic symptom disorder as: One or more physical (somatic) symptoms that are distressing or cause significant disruption in daily life […] The most current DSM-5-TR reflects a crucial change to the diagnostic criteria for somatic symptom disorder. In DSM-5-TR, the criteria for a somatic symptom disorder diagnosis no longer require that the symptoms causing distress are ‘medically unexplained,’ meaning that the patient may genuinely have real medical conditions causing the symptoms. Having a legitimate, identifiable medical condition causing the symptoms does not negate the excessive worry and anxiety the patient is experiencing. […] An individualized, interdisciplinary approach is recommended to manage the often debilitating symptoms of somatic symptom disorder effectively. Treating this condition requires careful consideration of a variety of factors, not just the physical symptoms themselves.

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