Somatic Symptom Disorder

  • At least 1 physical symptoms that are distressing or result in significant disruption of daily life
  • Excessive thoughts, feelings, or behaviors related to these symptoms
  • Persistent symptoms for at least 6 months

History and Controversy

Somatoform disorders in the DSM-IV-TR distinguished between 4 specific categories: somatisation disorder, hypochondriasis, pain disorder, and undifferentiated somatoform disorder. The DSM-5 replaced these with the single category: somatic symptom disorder, and introduced a new diagnosis: illness anxiety disorder. See the resource links below for further reading.

Comparison of DSM-IV-TR Somatoform Disorders

Somatic symptom disorder Excessive anxiety & preoccupation with > 1 unexplained symptoms
Illness anxiety disorder Fear of having a serious illness despite few or no symptoms and consistently negative investigations
Somatisation disorder A history of many physical complaints beginning before age 30 years that occur over a period of several years and result in treatment being sought or significant impairment in social, occupational, or other important areas of functioning.
Hypochondriasis Preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily symptoms
Pain disorder Pain in one or more anatomical sites is the predominant focus of the clinical presentation and is of sufficient severity to warrant clinical attention, where psychological factors are judged to have an important role in the onset, severity, exacerbation, or maintenance of the pain.
Undifferentiated somatoform disorder One or more physical complaints, that after appropriate investigation, the symptoms cannot be fully explained by a known general medical condition