Somatic Symptom Disorders somatic symptom disorders excessive or maladaptive response to physical symptoms or to associated health concerns preoccupation w health or appearance and functioning that dominates one s life somatic symptom disorders are often comorbid w anxiety mood disorders dissociative disorders feeling detached from yourself or your surroundings DSM 5 emphasizes diagnosis made on the basis of positive symptoms and signs vs DSM IV TR that emphasized the absence of a medical explanation for somatic symptoms we really don t know much about these disorders somatic symptom disorder you have physical symptoms with or without a clear medical cause that are compounded in severity and impairment by psychological and behavioral factors like anxiety and distress diagnostic criteria at least 1 distressing somatic symptom usually multiple excessive thoughts feelings and behaviors related to the somatic symptoms or associated health concerns as manifested by 1 of the following 1 disproportionate persistent thoughts about the seriousness of one s symptoms 2 high level of health related anxiety 3 excessive time energy devoted to these symptoms or health concerns although any one symptom may not be continuously present the state of being symptomatic is persistent for 6 months these somatic symptoms often involve pain and fatigue and although the physical symptoms may not have a clear cause the pain is real and it hurts the pain becomes part of their identity can occur w medical disorder prevalence 5 7 more common in females getting this diagnosis can feel dismissive for some people like the doctor isn t really trying to understand what s happening onset at any time there s a myth that it affects the elderly more but that s not true it s chronic why do people have this disorder has to do w cognitive appraisal the way you re responding to these bodily sensations leads to more distress focusing on pain having it become their identity but again there s no sure reason for why someone has it there is a family history but that said the actual genetic contributions are unclear we don t have well established treatments for this might try to challenge their illness related misinterpretations anti depressants might help even though it might be helping other symptoms teach them stress management coping strategies primary source of distress the pain you are currently experiencing illness anxiety disorder physical symptoms are either not experienced at the present time or are very mild but the individual has severe anxiety about the possibility of having or developing a serious disease concern is primarily w the idea of being sick rather than w the physical symptom itself as is the case in somatic symptom disorder high health anxiety w out focus on one specific somatic symptom high anxiety about health or person is easily alarmed about personal health status excessive health related behaviors or maladaptive avoidance i e avoiding ppl w colds persistent concerns for at least 6 months but not necessarily about the same illness association w hypochondriasis characteristics alarmed easily by others bad health or by news i e news of a flu outbreak health concerns can assume a central role in their life primary source of distress the possibility that you could develop have a disease both characterized by anxiety or fear that one has a serious disease misinterpretation of physical signs and sensations as evidence of physical illness disorders of cognition or perception w strong emotional contributions reassurance from numerous doctors that they are healthy doesn t relieve their anxiety b c these ppl have a disease conviction meaning that they mistakenly believe they have a disease these ppl continue going to additional doctors in an attempt to rule out or confirm disease and are likely to demand unnecessary medical treatment 1 5 of general population typical onset during adolescence these disorders are chronic suicidal attempts as manipulative gestures rather than true death efforts overuse and misuse of the healthcare system 19 are on disability koro in China is due to importance of sexual functioning of males in Chinese culture dhat in India is an anxious concern about losing semen aside from biological and psychological vulnerabilities to anxiety 3 other factors may contribute to somatic symptom disorders 1 these disorders often develop in the context of a stressful life event like anxiety disorders 2 ppl who develop these disorders often have had a disproportionate incidence of disease in their family when they were young memories of illness that could become focus of anxiety 3 ppl who come from families w prominent illness learn that ill ppl get lots of attention and get to avoid work responsibilities so these benefits of being sick may contribute to the development of the disorder a sick person who receives attention benefits is described as adopting a sick role interesting findings show a strong link btwn somatic symptom disorders and antisocial personality disorder ASPD in family genetic studies these two disorders while manifested very differently share a neurobiologically based disinhibition syndrome categorized by impulsive behavior in ASPD this impulsiveness is reflected in vandalism crime etc but in somatic symptom disorders it is reflected in the impulsive characteristic of short term gain continual development of new symptoms sympathy for a while at the expense of long term problems eventual social isolation the different manifestations of the same genetic impulsiveness can be explained by gender roles ASPD more common in males independence aggression and somatic symptom disorders more common in females dependence less aggression overall little is known about treating these disorders but we have some recent evidence to support some treatments explanatory therapy which provides continuous reassurance and explanation of the nature of the patient s disorder in an educational framework by a mental health professional is successful in reducing fears beliefs about somatic symptoms and a decrease in health care usage for those with mild forms of somatic symptom disorders participation in support groups may also help CBT that focuses on identifying and challenging illness related misinterpretation of physical sensations and showing patients that focusing on a particular area of their body can bring about symptoms helps make ppl feel like the symptoms are under their control and is highly