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Overview of Somatic Symptom and Related Disorders

By Joel E. Dimsdale, MD, 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, 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:

  • In conversion disorder, physical symptoms that resemble those of a nervous system disorder develop (see Conversion Disorder).

  • In factitious disorder (see Factitious Disorder Imposed on Self), people pretend to have symptoms for no apparent external reason (such as to get time off from work).

  • In illness anxiety disorder (see Illness Anxiety Disorder), people are excessively preoccupied and worried about the possibility of having or getting a serious illness.

  • Sometimes attitudes or behaviors can have a negative effect on a medical disorder that a person has (see Psychological Factors Affecting Other Medical Conditions).

  • In somatic symptom disorder (see Somatic Symptom Disorder), people's symptoms concern and preoccupy them, worry them constantly, and/or drive them to see doctors very frequently.

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.

Children are also affected (see Overview of Mental Health Disorders in Children).

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

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