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Somatic Symptom (Somatization) Disorder

William G. Elder, PhD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A pattern of one or more somatic symptoms recurring or persisting for >6 months that are distressing or result in significant disruption of daily life

  • Conceptualization and diagnos...

DIAGNOSIS

  • Determining that a somatic symptom is medically unexplained is unreliable, and it is inappropriate to diagnose a mental disorder solely because a medical diagnosis is not demonstrated. Rely ...

TREATMENT

GENERAL MEASURES

  • The goal of treatment is to help the person learn to control the symptoms (1)[B].

  • A supportive relationship with a sympathetic health care provider is the most important aspec...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patients should have regularly scheduled follow-up with a primary care doctor, psychiatrist, and/or therapist. 

PATIENT EDUCATION

Encourage interventions that decre...

REFERENCES

1
Heijmans M, Olde Hartman TC, van Weel-Baumgarten E, et al. Experts’ opinions on the management of medically unexplained symptoms in primary care. A qualitative analysis of narrative review...

ADDITIONAL READING

  • Elder WGJr, King M, Dassow P, et al. Managing lower back pain: you may be doing too much. J Fam Pract.  2009;58(4):180–186. [View Abstract on OvidMedline]

  • Sharma MP, Manjula M....

CODES

ICD10

  • F45.9 Somatoform disorder, unspecified

  • F45.20 Hypochondriacal disorder, unspecified

  • F45.22 Body dysmorphic disorder

  • F45.29 Other hypochondriacal disorders

  • F45.41 Pain disorder exclusively relat...

CLINICAL PEARLS

  • With the advent of DSM-5, diagnosis is now based on a pattern of symptoms rather than an absence of medical explanation.

  • A clue is accumulation of several diagnoses with >13 letters ...

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