On This Page:ToggleWhat is Somatic Symptom Disorder?Risk FactorsSymptomsDiagnosisTreatment OptionsSDD vs. Illness Anxiety DisorderSDD vs. Conversion Disorder
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Somatoform disorders involve physical symptoms suggesting illness or injury that any medical condition cannot fully explain. Symptoms are real and cause significant distress or impairment, but psychological factors like stress or trauma are likely involved in their manifestation.
Key Points
a man with his head on a table, hands on his head
What is Somatic Symptom Disorder?
It is diagnosed when an individual experiences excessive thoughts, feelings, and behaviors related to their physical symptoms, often leading to frequent doctor visits and medical tests.
Somatic symptom disorder is a term introduced in the DSM-5 to replace somatization disorder and hypochondriasis.
Somatic symptom disorder (SSD) falls under the umbrella of somatoform disorders. Somatoform disorders are disorders in which thoughts, actions, and emotions correlate to somatic symptoms. The DSM-5 outlines seven main variations of Somatoform disorders as follows:
In SDD, a person has an excessive preoccupation with physical symptoms, such as pain, weakness, or shortness of breath, which impairs optimal daily functioning.
Oftentimes patients have disproportionate amounts of anxiety correlated to their physical symptoms.
These physical symptoms may or may not be associated with an underlying medical condition. In SDD, individuals may experience excessive thoughts, feelings, and behaviors relating to the symptoms, making them believe they are sick.
These patients frequently seek care and continue to search for an explanation for their symptoms even when other serious conditions have been excluded.
Risk Factors
Factors that make a person more at risk of having somatic symptom disorder include:
Symptoms
Some of the key symptoms of somatic symptom disorder
Pain in any area of the bodyPain during sexual activity or menstruationHeadachesFatigueDizzinessFaintingWeaknessConstipationDiarrheaDigestive issuesBreathing difficulties
Excessive preoccupation with physical symptomsPhysical health concerns are the main focus in lifeConstantly visiting physicianReporting normal sensations or discomfort to the physician due to catastrophizing the symptomIrrationally worrying about medical conditions that have been ruled outDissatisfied with health treatment and assuming that the physician is not taking you seriouslySensitive to the side effects of drugs
Intrusive thoughts about physical symptomsFeeling anxiousSeek to be taken care ofDepressionFear and anxiety, even when they are shown evidence of no serious illness.
DiagnosisTo be diagnosed with SDD, a person must exhibit one of the following criteria:One or more physical symptoms disturb and disrupt the normal functioning of daily life.Excessive thoughts, feelings, and behaviors related to physical symptoms (such as ongoing thoughts that are out of proportion to the seriousness of symptoms, ongoing high levels of anxiety, and excessive time/energy spent on health concerns).Although symptoms may be different, at least one of them must be constant, and symptoms may come and go.
Diagnosis
To be diagnosed with SDD, a person must exhibit one of the following criteria:
Treatment Options
If left untreated, somatic symptom disorder can lead to poor health, problems functioning in daily life, physical disability, relationship problems, work problem, and unemployment.
Other complications may include co-occurring mental health disorders, such as anxiety, depression, and personality disorders, and increased suicide risk related to depression.
These individuals also face financial problems due to recurrent healthcare visits and excessive medication usage.
Medication
In case of a co-occurring condition, such as anxiety or depression,antidepressant medicationsmay be used.
These medications alone cannot resolve somatic symptoms, but they help alleviate the symptoms of associated co-occurring conditions, particularly when combined withpsychotherapy.
Psychotherapy
Cognitive-behavioral therapy(CBT) is the most commonly used treatment option focused on helping people better manage their thoughts and behaviors.
CBT can help them learn how to decrease their preoccupation with their symptoms and engage more optimally in their daily routine.
Hypnosis
Hypnosis is effective in pain relief, the most frequently reported symptom in those struggling with SDD.
When to see a doctorSomatic symptom disorder affects the daily life of many individuals, and you should contact your healthcare provider if you feel so concerned about physical symptoms that you can’t function or if you have symptoms of anxiety or depression.The doctor will evaluate you accordingly and will ensure proper treatment according to the symptoms and underlying cause.Co-occurring conditions associated with Somatic Symptom Disorder (SSD)SDD often co-occurs with psychological disorders such as anxiety and depression, which may be the cause of SDD. It is crucial for these conditions to be addressed for optimal recovery.To cope with the uncomfortable feelings associated with SDD, many individuals may turn to drugs and alcohol hence why substance abuse is a common co-occurring condition in SDD.
When to see a doctor
Somatic symptom disorder affects the daily life of many individuals, and you should contact your healthcare provider if you feel so concerned about physical symptoms that you can’t function or if you have symptoms of anxiety or depression.
The doctor will evaluate you accordingly and will ensure proper treatment according to the symptoms and underlying cause.
Co-occurring conditions associated with Somatic Symptom Disorder (SSD)
SDD often co-occurs with psychological disorders such as anxiety and depression, which may be the cause of SDD. It is crucial for these conditions to be addressed for optimal recovery.
To cope with the uncomfortable feelings associated with SDD, many individuals may turn to drugs and alcohol hence why substance abuse is a common co-occurring condition in SDD.
SDD vs. Illness Anxiety Disorder
Illness anxiety disorder (IAD), previously known as hypochondriasis, is the obsession with the idea of being ill. It does not typically involve any somatic symptoms, but individuals complain about having a medical illness.
IAD is the focus on an illness, while SDD is the focus on a specific symptom.
According to the DSM-5, two types of patients fall under illness anxiety disorder, the care-seeking ones and the care-avoidant ones.
SDD vs. Conversion Disorder
Conversion disorder, also known as Functional Neurological Symptom Disorder, is a psychological condition in which patients present involuntary neurological symptoms which do not fit any neurological disorder.
An example of this is pseudo seizures, in which a person displays signs of convulsions or jerking that match a seizure, yet there is no abnormal EEG activity.
In SDD, symptoms are usually catastrophized, and much of the impairment to daily functioning results from the emotional consequences.
Further Information
Dimsdale, J. E., Creed, F., Escobar, J., Sharpe, M., Wulsin, L., Barsky, A., … & Levenson, J. (2013). Somatic symptom disorder: an important change in DSM. Journal of psychosomatic research, 75(3), 223-228.
Katz, J., Rosenbloom, B. N., & Fashler, S. (2015). Chronic pain, psychopathology, and DSM-5 somatic symptom disorder. The Canadian Journal of Psychiatry, 60(4), 160-167.
Kurlansik, S. L., & Maffei, M. S. (2016). Somatic symptom disorder. American family physician, 93(1), 49-54.
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). American Psychiatric Association.Frances, A. (2013). The new somatic symptom disorder in DSM-5 risks mislabeling many people as mentally ill.Bmj,346.French, J. H., & Hameed, S. (2021).Illness Anxiety Disorder. In StatPearls. StatPearls Publishing.Hasin, D., & Katz, H. (2007). Somatoform and substance use disorders.Psychosomatic Medicine, 69(9), 870–875.Henningsen P. (2018). Management of somatic symptom disorder.Dialogues in Clinical Neuroscience, 20(1), 23–31.Hurwitz T. A. (2004). Somatization and conversion disorder. Canadian journal of psychiatry.Revue canadienne de psychiatrie, 49(3), 172–178.Kallivayalil, R. A., & Punnoose, V. P. (2010). Understanding and managing somatoform disorders: Making sense of non-sense.Indian journal of psychiatry, 52(Suppl 1), S240–S245.Kurlansik, S. L., & Maffei, M. S. (2016). Somatic Symptom Disorder.American family physician, 93(1), 49–54.Thompson, T., Terhune, D. B., Oram, C., Sharangparni, J., Rouf, R., Solmi, M., Veronese, N., & Stubbs, B. (2019). The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials.Neuroscience and biobehavioral reviews, 99, 298–310.
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). American Psychiatric Association.
Frances, A. (2013). The new somatic symptom disorder in DSM-5 risks mislabeling many people as mentally ill.Bmj,346.
French, J. H., & Hameed, S. (2021).Illness Anxiety Disorder. In StatPearls. StatPearls Publishing.
Hasin, D., & Katz, H. (2007). Somatoform and substance use disorders.Psychosomatic Medicine, 69(9), 870–875.
Henningsen P. (2018). Management of somatic symptom disorder.Dialogues in Clinical Neuroscience, 20(1), 23–31.
Hurwitz T. A. (2004). Somatization and conversion disorder. Canadian journal of psychiatry.Revue canadienne de psychiatrie, 49(3), 172–178.
Kallivayalil, R. A., & Punnoose, V. P. (2010). Understanding and managing somatoform disorders: Making sense of non-sense.Indian journal of psychiatry, 52(Suppl 1), S240–S245.
Kurlansik, S. L., & Maffei, M. S. (2016). Somatic Symptom Disorder.American family physician, 93(1), 49–54.
Thompson, T., Terhune, D. B., Oram, C., Sharangparni, J., Rouf, R., Solmi, M., Veronese, N., & Stubbs, B. (2019). The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials.Neuroscience and biobehavioral reviews, 99, 298–310.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Misha JanResearch Assistant at Carleton UniversityUndergraduate Psychology & NeuroscienceMisha Jan is a psychology and neuroscience student at Carleton University and works as a research assistant at The Royal Mental Health Hospital.
Misha JanResearch Assistant at Carleton UniversityUndergraduate Psychology & Neuroscience
Misha Jan
Research Assistant at Carleton University
Undergraduate Psychology & Neuroscience
Misha Jan is a psychology and neuroscience student at Carleton University and works as a research assistant at The Royal Mental Health Hospital.
