Somatic symptom disorder: Difference between revisions
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Revision as of 17:40, 13 November 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]
Overview
Somatic symptom disorder is characterized by the presence of one or more somatic symptoms with excessive thoughts and behaviors associated with health concerns. [1]
Differential Diagnosis
- Anxiety disorder
- Body dysmorphic disorder
- Diabetes
- Heart disease
- Irritable bowel syndrome
- Fibromyalgia
- Panic disorder
- Obsessive-compulsive disorder[1]
Epidemiology and Demographics
Prevalence
The prevalence of somatic symptom disorder is 5,000 to 7,000 per 100,000 (5-7%) of the overall population.[1]
Risk Factors
- Negative affectivity (neuroticism)
- Comorbid anxiety
- Depression
- Few years of education
- Lower socioeconomic status
- History of sexual abuse[1]
Natural History, Complications and Prognosis
Poor prognostic factors include:
- Depression
- Anxiety
- Persistent depressive disorder (dysthymia)
- Panic disorder
- Social stress
- Illness benefits[1]
Diagnostic Criteria
DSM-V Diagnostic Criteria for Somatic Symptom Disorder[1]
A. One or more somatic symptoms that are distressing or result in significant disruption of daily life.
AND
B. Excessive thoughts, feelings, or behaviors 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.
AND
C. Although anyone somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).
Specify if:
- With predominant pain (previously pain disorder): This specifier is for individuals whose somatic symptoms predominantly involve pain.
Specify if:
- Persistent: A persistent course is characterized by severe symptoms, marked impairment, and long duration (more than 6 months).
Specify current severity:
- 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).