Somatic symptom disorder

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Somatic symptom disorder

Psychological disorders

Mood disorders

Major depressive disorder

Suicide

Bipolar disorder

Seasonal affective disorder

Premenstrual dysphoric disorder

Anxiety disorders

Generalized anxiety disorder

Social anxiety disorder

Panic disorder

Agoraphobia

Phobias

Obsessive-compulsive disorders

Obsessive-compulsive disorder

Body focused repetitive disorders

Body dysmorphic disorder

Stress-related disorders and abuse

Post-traumatic stress disorder

Physical and sexual abuse

Psychotic disorders

Schizoaffective disorder

Schizophreniform disorder

Delusional disorder

Schizophrenia

Cognitive and dissociative disorders

Delirium

Amnesia

Dissociative disorders

Eating disorders

Anorexia nervosa

Bulimia nervosa

Personality disorders

Cluster A personality disorders

Cluster B personality disorders

Cluster C personality disorders

Somatoform and factitious disorders

Somatic symptom disorder

Factitious disorder

Substance use disorders and drugs of abuse

Tobacco dependence

Opioid dependence

Cannabis dependence

Cocaine dependence

Alcohol use disorder

Sleep disorders

Bruxism

Nocturnal enuresis

Insomnia

Night terrors

Narcolepsy (NORD)

Sexual dysfunction disorders

Erectile dysfunction

Male hypoactive sexual desire disorder

Orgasmic dysfunction

Female sexual interest and arousal disorder

Genito-pelvic pain and penetration disorder

Pediatric disorders

Attention deficit hyperactivity disorder

Disruptive, impulse control, and conduct disorders

Learning disability

Fetal alcohol syndrome

Tourette syndrome

Autism spectrum disorder

Rett syndrome

Shaken baby syndrome

Enuresis

Encopresis

Psychiatric emergencies

Suicide

Serotonin syndrome

Neuroleptic malignant syndrome

Psychological disorders review

Mood disorders: Pathology review

Amnesia, dissociative disorders and delirium: Pathology review

Personality disorders: Pathology review

Eating disorders: Pathology review

Psychological sleep disorders: Pathology review

Psychiatric emergencies: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Malingering, factitious disorders and somatoform disorders: Pathology review

Anxiety disorders, phobias and stress-related disorders: Pathology Review

Trauma- and stress-related disorders: Pathology review

Schizophrenia spectrum disorders: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Drug misuse, intoxication and withdrawal: Alcohol: Pathology review

Developmental and learning disorders: Pathology review

Childhood and early-onset psychological disorders: Pathology review

Assessments

Somatic symptom disorder

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Somatic symptom disorder

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Questions

USMLE® Step 1 style questions USMLE

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A 17-year-old girl presents to her primary care physician to evaluate right leg weakness for two weeks. The patient states, “I can’t lift my right leg, and it feels numb too. I haven’t been able to walk or go to school because of my symptoms.” The patient's parent states, “I don’t know what’s wrong. I know school has been hard this year with her applying to college, but all of this just came out of the blue.” The patient is otherwise healthy and neither uses illicit substances nor consumes alcohol. Vital signs are within normal limits. The patient has 2+ symmetric reflexes in the bilateral lower extremities on physical examination. Plantar reflex testing results in flexion of the big toe bilaterally. While the patient lies supine, the physician places a hand under the right heel; when asked to lift the left leg against resistance, the patient exerts downward pressure with the right heel. Further history gathering is most likely to reveal which of the following?  

External References

First Aid

2022

2021

2020

2019

2018

Hypochondriasis p. 589

Illness anxiety disorder p. 589

Somatic symptom disorder p. 589

External Links

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Tanner Marshall, MS

Somatic symptom disorder, which used to be called somatization or somatoform disorder, involves physical symptoms that aren’t explained by any known physical or mental disorder; in other words, their origins are unknown.

That said, individuals aren’t “faking” their symptoms; these symptoms are very real and often made worse by the fact that they cannot be scientifically explained.

This is pretty different from situations where an individual with a factitious disorder might fake an illness or injury in order to get attention.

A diagnosis of somatic symptom disorder requires that individuals experience some set of unexplained physical symptoms, called somatic symptoms, for a period of at least 6 months.

The symptoms experienced by individuals with this disorder can be incredibly varied, encompassing anything from pain to gastrointestinal problems to sexual symptoms.

Although the somatic symptoms being experienced are chronic, the exact location, kind, and severity of the symptoms typically changes over time.

The one symptom that does often persist over time is chronic pain, and because it’s persistent and has no clear underlying cause, it can be particularly hard to treat.

Somatic symptom disorder often leads to cognitive symptoms as well, with people having persistent thoughts and feelings about their symptoms, like worry and anxiety, and sometimes in particularly bad cases, catastrophic thoughts about death.

More often than not, it’s these cognitive symptoms felt in response to the physical symptoms, rather than the physical symptoms themselves, that are used as the basis for a diagnosis of somatic symptom disorder.

In fact, clinicians rate the severity of somatic symptom disorder based on the person’s experience with these cognitive symptoms, rather than the physical ones.

The condition is considered mild if there’s only one cognitive symptom, like ruminating a lot on the symptoms.

It would be considered moderate if there are two or more cognitive symptoms, like rumination and anxiety.

Summary

Somatic symptom disorder (SSD), formerly known as somatoform disorder, is a mental health condition characterized by somatic symptoms that are not fully explained by a medical condition and are followed by excessive thought, feeling, and behaviors related to somatic symptoms. People with SSD experience significant distress and impairment in daily functioning. The symptoms can range from pain, fatigue, and digestive problems to sexual dysfunctions and sensory symptoms. Treatment for SSD typically involves a combination of psychotherapy and medication. The goal of treatment is to help manage symptoms and improve quality of life.

Elsevier

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