psychiatric disorders
Somatic Symptom Disorder
Introduction
Somatic symptom disorder is characterized by multiple persistent physical complaints that are associated with excessive and maladaptive thoughts, feelings, and behaviors related to those symptoms. The symptoms are not intentionally produced or feigned and may or may not accompany known medical illness. Diagnosis is based on history from the patient and occasionally from family members. Treatment focuses on establishing a consistent, supportive physician-patient relationship that avoids exposing the patient to unnecessary diagnostic testing and therapies. (See also Overview of Somatization .) Some previously distinct somatic disorders—somatization disorder, undifferentiated somatoform disorder, Illness Anxiety Disorder , and somatoform pain disorder—are now considered somatic symptom disorders. All have common features, including somatization—the expression of mental phenomena as physical (somatic) symptoms. The symptoms may or may not be associated with another medical problem; symptoms no longer have to be medically unexplained but are characterized by the patient having disproportionately excessive thoughts, feelings and concerns about them. Sometimes the symptoms are normal body sensations or discomfort that do not signify a serious disorder. Patients are commonly unaware of their underlying psychiatric issue and believe that they have physical ailments, so they typically continue to pressure physicians for additional or repeated tests and treatments even after results of a thorough evaluation have been negative. 