Conversion disorder and somatic symptom disorder are both categorized as somatic symptom and related disorders (previously termed somatoform disorders). Show Somatic symptom and related disorders are psychiatric conditions where patients experience distressing physical symptoms associated with abnormal thoughts, feelings, and behaviors in response to these symptoms. They may result from psychological stress that is unconsciously (without awareness) expressed somatically, though the underlying cause is not fully understood. Risk factors include being female, having a history of abuse or adverse childhood events, and having personality traits of alexithymia (difficulty expressing emotions) or neuroticism. Symptoms that persist with an external focus of control, and without awareness of the psychological and stress-related interplay, can lead to considerable functional impairment and distress. Diagnosis is made by clinical interview, behavioral observation, physical exam suggestive of pseudoneurologic causes, and tests to rule out medical or neurologic causes. The diagnosis should not be made solely on the basis of medically unexplained symptoms; rather, it should be based on evidence from the clinical exam and the patient’s abnormal thoughts, feelings, and behaviors in response to the medically unexplained symptoms. Good doctor-patient relationships and validation of the patient's suffering are essential for effective management. Treatment includes cognitive behavioral therapy, physical therapy, and avoiding unnecessary medicines, tests, and procedures. Diagnosis and treatment of associated comorbid psychiatric conditions benefit overall functioning and recovery. Long-term management involves interrupting perpetuating factors, maintaining the same doctor, and providing strategies for self-efficacy, distress tolerance, coping, and modulating the interaction of anxiety, stress, and physical symptoms. Somatic Symptom Disorder is a mental disorder characterized by multiple, current, somatic symptoms that are distressing or result in significant disruption of daily life. Commonly, only one severe symptom, pain is present. The individual's suffering is authentic, whether or not it is medically explained. The diagnoses of somatic symptom disorder and a concurrent medical illness are not mutually exclusive, and these frequently occur together. Epidemiology
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HistorySee main article: Somatic Disorders: DSM-IV to DSM-5 Changes DSM-IV to DSM-5 ChangesSee also: DSM-IV to DSM-5 Illness Anxiety Disorder Comparison
DSM-5 Diagnostic CriteriaCriterion A
Criterion BExcessive thoughts, feelings, or behaviours related to the somatic symptoms or associated health concerns as manifested by at least
Criterion CAlthough any In children, the most common symptoms are recurrent abdominal pain, headache, fatigue, and nausea. A single prominent symptom is more common in children than in adults. While young children may have somatic complaints, they rarely worry about “illness” per se prior to adolescence. The parents' response to the symptom is important, as this may determine the level of associated distress. It is the parent who may determine the interpretation of symptoms and the associated time off school and medical help seeking. SpecifiersSpecifiers
Severity Specifier
Signs and Symptoms
Differential Diagnosis
Comparison of Somatic DisordersFig. 1 TreatmentEducation
Psychotherapy
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ResourcesFor PatientsFor ProvidersArticlesResearchReferences1) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA. What are the somatic symptom disorders in the DSMSomatic 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.
What are somatic symptom and related disorders?Somatic symptom and related disorders (SSDs) are a group of diseases in which youth have physical symptoms that are either very distressing or result in significant disruption of their daily functioning, as well as excessive thoughts, feelings, and behaviors regarding those symptoms.
What are the 5 somatic disorders?They include somatization disorder, undifferentiated somatoform disorder, hypochondriasis, conversion disorder, pain disorder, body dysmorphic disorder, and somatoform disorder not otherwise specified. These disorders often cause significant emotional distress for patients and are a challenge to family physicians.
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