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Overview of Somatic Symptom and Related Disorders

By Joel E. Dimsdale, MD, Professor Emeritus, Department of Psychiatry, University of California, San Diego

Somatic symptom and related disorders are mental health disorders characterized by an intense focus on physical (somatic) symptoms, which cause significant distress and/or interfere with daily functioning.

Most mental health disorders are characterized by mental symptoms. That is, people have unusual or disturbing thoughts, moods, and/or behaviors. However, in somatic symptom disorders, mental factors are expressed as physical symptoms—a process called somatization—and the person's main concern is with physical (somatic—from soma, the Greek word for body) symptoms, such as pain, weakness, fatigue, nausea, or other bodily sensations. The person may or may not have a medical disorder that causes or contributes to the symptoms. However, when a medical disorder is present, the person responds to it excessively.

Everyone reacts on an emotional level when they have physical symptoms. However, people with a somatic symptom disorder have exceptionally intense thoughts, feelings, and behaviors in response to their symptoms. To distinguish a disorder from a normal reaction to feeling ill, the responses must be intense enough to cause significant distress to the person (and sometimes to others) and/or make it difficult for the person to function in daily life.

The different responses people have define the specific disorder they have, as in the following:

Because people with one of these disorders think they have physical symptoms, they tend to go to a doctor rather than to a mental health care practitioner.

Somatic symptom or related disorders may also occur in children.

Treatment varies according to which disorder a person has but usually involves psychotherapy.

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