Somatic symptoms Disorder

A few individuals, the preoccupation with their health or appearance becomes so great that it dominates their lives. Their problems fall under the general heading of somatic symptoms disorder.

Soma means body, and the problems preoccupying these people seem, initially, to be physical disorders. What the somatic symptom disorders have in common is that there is an excessive or maladaptive response to physical symptoms or to associated health concerns.

These disorders are sometimes grouped under the shorthand label of “medically unexplained physical symptoms”. But in some cases the medical cause of the presenting physical symptoms is known but the emotional distress or level of impairment in response to this symptom is clearly excessive and may even make the condition worse.

Somatic symptoms disorder, illness anxiety disorder, and psychological factors affecting medical condition—overlap considerably since each focuses on a specific.

Five basic somatic symptom and related disorders: somatic symptom disorder, illness anxiety disorder, psychological factors affecting medical condition, conversion disorder and factitious disorder. In each, individuals are pathologically concerned with the functioning of their bodies.


Somatic Symptom Disorder.

Somatic symptom, or set of symptoms, about which the patient is so excessively anxious or distressed that it interferes with their functioning, or, the anxiety or distress is focused on just the possibility of developing an illness as in illness anxiety disorder.

Example of a somatic symptom disorder would be the experience of severe pain in which psychological factors play a major role in maintaining or exacerbating the pain whether there is a clear physical reason for the pain or not.

Once again, the important factor in this condition is not whether the physical symptom, in this case pain, has a clear medical cause or not, but rather that psychological or behavioral factors, particularly anxiety and distress, are compounding the severity and impairment associated with the physical symptoms.

Diagnostic Criteria for Somatic Symptom Disorder.

A. One or more somatic symptoms that are distressing and/or result in significant disruption of daily life.

B. Excessive thoughts, feelings, and 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. High level of health-related anxiety.
3. Excessive time and energy devoted to these symptoms or health concerns.

C. Although any one symptom may not be continuously present, the state of being symptomatic is persistent:

Specify if:

With predominant pain (previously pain disorder): This specifier is for individuals whose somatic complaints predominantly involve pain.

Specify current severity:

Mild: Only one of the symptoms 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.


Physical symptoms that people with SSD may have include:

  • Pain (the most commonly reported symptom).
  • Fatigue or weakness.
  • Shortness of breath (dyspnea).

The physical symptoms may be mild to severe, and there may be one or multiple symptoms. They may be due to a medical condition or have no clear cause.

  • Feel extreme anxiety about their physical symptoms.
  • Feel concerned that mild physical symptoms are signs of serious conditions.
  • See their healthcare provider for multiple diagnostic tests and exams but not believe the results.
  • Feel that their healthcare provider doesn’t take their physical symptoms seriously enough.
  • Go from one healthcare provider to another or seek treatment from multiple providers at once.
  • Spend excessive amounts of time and energy dealing with health concerns.


Childhood physical and sexual abuse can develop somatic symptoms disorder. Poor awareness of emotions or emotional development during childhood. This can be the result of parental neglect or a lack of emotional closeness. Excessive anxiety and attention to bodily processes and possible signs of illness.

The emotional distress of anxiety is often accompanied by specific physical symptoms associated with a state of autonomic arousal, such as sweating, dizziness, and shortness of breath (most notable in patients with panic attacks), or more generalized somatic complaints, such as insomnia, restlessness, and muscle aches.


David H. Barlow, V. Mark Durand. Abnormal Psychology, An Integrative Approach. (7th ed).

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