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Overview of Somatic Symptom and Related Disorders


Joel E. Dimsdale

, MD, University of California, San Diego

Reviewed/Revised Aug 2022 | Modified Sep 2022
Topic Resources

Somatic symptom and related disorders are mental health disorders characterized by an intense focus on physical (somatic) symptoms that causes significant distress and/or interferes with daily functioning.

Most mental health disorders are characterized by mental symptoms Personality and Behavior Changes Healthy people differ significantly in their overall personality, mood, and behavior. Each person also varies from day to day, depending on the circumstances. However, a sudden, major change... read more . 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, a person with somatic symptom or a related disorder 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 these disorders think they have physical symptoms, they tend to go to a doctor rather than to a mental health care practitioner.

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

Mind and Body

How the mind and body interact to influence health has long been discussed. Although people speak casually about mind and body as though they were distinct, they are actually so interrelated that it is hard to separate their effects, as in the following cases:

  • Social and mental stress can aggravate many physical disorders, including diabetes mellitus, coronary artery disease, and asthma.

  • Stress and other mental processes can aggravate or prolong physical symptoms. For example, people who are depressed or anxious may suffer more if they become ill or injured than people who are in a better frame of mind.

  • Stress sometimes can contribute to physical symptoms even when no physical disorder is present. For example, children may develop abdominal pain or nausea because they are anxious about going to school, or adults may develop a headache when they are under emotional stress.

  • Thoughts and ideas can influence how a disorder progresses. For example, people with high blood pressure may deny that they have it or that it is serious. Denial may help reduce their anxiety, but it may also prevent them from following their treatment plan. For example, they may not take their prescribed drugs, thus worsening their disorder.

  • A general physical disorder can influence or lead to a mental health problem. For example, people with a life-threatening, recurring, or chronic physical disorder may become depressed. The depression, in turn, may worsen the impact of the physical disorder.

  • A physical disorder of the brain, such as Alzheimer disease, can affect someone's personality and/or ability to think clearly.

When physical symptoms result from stress or mental factors, doctors may have difficulty identifying the cause. Various diagnostic tests may be required to clarify the situation.

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