Somatic Symptom and Related
Disorders
- All disorders in this group have prominent somatic symptoms that are
associated with significant impairment or distress
- Somatic symptoms- physical or bodily symptoms
- Actual physical illness may or may not be present
- Abnormal thoughts, feelings and behaviors in response to these
symptoms
Disorder DSM-5 Criteria
Somatic Symptom Disorder At least on distressing somatic
symptom and one of the following:
- Persistent thoughts
- High anxiety
- Excessive time devoted to
symptoms
Illness Anxiety Disorder - Preoccupation with health and
excessive worry about serious
illness
, - No somatic symptoms or very
mild symptoms
- Excessive health anxiety
- Repeatedly checks for signs of
illness or avoids medical contact
for fear that illness with be
confirmed
Conversion Disorder - Motor or sensory disturbances
- Symptoms incompatible with
medical findings
Factitious Disorder, imposed on self or - Physical or mental symptoms
others fabricated or induced in oneself
or others
- Presents self or others as ill or
injured
- Absence of external rewards for
illness
Somatic Symptom Disorder
- Pattern of reporting and reacting to pain or other distressing physical or
bodily symptoms, occurs for at least 6 months and also involves
persistent thoughts or high anxiety regarding symptoms
- Excessive focus on somatic symptoms and catastrophic thoughts related
to these symptoms
- Diagnostic tests that rule out disease or other physical conditions do little
to reassure individuals with SSD or reduce their anxiety
- Symptoms may or may not be associated with another medical condition
- Somatic symptom disorder with predominant pain- persistently high
levels of distress over pain along with an excessive amount of time and
energy devoted to the pain symptoms
Illness Anxiety Disorder
- A chronic pattern (at least 6 months) of preoccupation with having or
contracting a serious illness
- Minimal or no somatic symptoms
- Very anxious and easily alarmed about their health
- Continual checking of ones body or avoidance behaviors
- Individual misinterprets bodily variations or sensations as indications of
a serious illness- extreme distress and alarm
- People with illness anxiety disorder have strong tendency to:
o Catastrophize
o Overgeneralize
o Display all-or-none thinking
, o Show selective attention
- Frequently check for signs of illness, seek reassurance from others,
continuously research and gather information on diseases, and avoid
activities or circumstances they believe might result in an illness
DSM-5 diagnostic criteria for Illness Anxiety Disorder
A. Preoccupation with having, or acquiring a serious illness.
B. Somatic symptoms are not present or, if present, are only mild in intensity. If
another medical condition is present or there is a high risk for developing a
medical condition (e.g., strong family history is present), the preoccupation is
clearly excessive or disproportionate.
C. There is a high level of anxiety about health, and the individual is easily
alarmed about personal health status.
D. The person performs excessive health related behaviors (e.g., repeatedly check
his or her body for illness) or exhibits maladaptive avoidance (e.g., avoids
doctor appointments or hospitals).
E. Illness preoccupation has been present for at least 6 months, but the specific
illness that is feared may change over that period of time.
F. The illness-related preoccupation is not better explained another mental
disorder such as Somatic Symptom Disorder, Panic Disorder, Generalized
Anxiety Disorder, Body Dysmorphic Disorder, Obsessive-Compulsive Disorder,
or Delusional Disorder, somatic type.
Specify whether:
• Care-seeking type: Medical care, including physician visits or undergoing tests
and procedures, is frequently used.
• Care-avoidant type: Medical care is rarely used.
Conversion Disorder (Functional
Neurological Symptom Disorder)
- Motor, sensory, or seizure like symptoms that are inconsistent with any
recognized neurological or medical disorder and result in significant
distress or impairment in life activities
- Muscle weakness, paralysis, unusual movements, swallowing difficulties
and problems with speech
- Psychogenic movement disorders- disturbances of stance or walking,
sensory symptoms- blindness, dizziness, loss of voice
- Diagnosis confirmed when symptoms incompatible with neurological
findings
- Glove anesthesia, inability to talk or whisper combined with the ability to
cough- easily diagnosed symptoms
- Not malingering- feigning illness for an external purpose
Disorders
- All disorders in this group have prominent somatic symptoms that are
associated with significant impairment or distress
- Somatic symptoms- physical or bodily symptoms
- Actual physical illness may or may not be present
- Abnormal thoughts, feelings and behaviors in response to these
symptoms
Disorder DSM-5 Criteria
Somatic Symptom Disorder At least on distressing somatic
symptom and one of the following:
- Persistent thoughts
- High anxiety
- Excessive time devoted to
symptoms
Illness Anxiety Disorder - Preoccupation with health and
excessive worry about serious
illness
, - No somatic symptoms or very
mild symptoms
- Excessive health anxiety
- Repeatedly checks for signs of
illness or avoids medical contact
for fear that illness with be
confirmed
Conversion Disorder - Motor or sensory disturbances
- Symptoms incompatible with
medical findings
Factitious Disorder, imposed on self or - Physical or mental symptoms
others fabricated or induced in oneself
or others
- Presents self or others as ill or
injured
- Absence of external rewards for
illness
Somatic Symptom Disorder
- Pattern of reporting and reacting to pain or other distressing physical or
bodily symptoms, occurs for at least 6 months and also involves
persistent thoughts or high anxiety regarding symptoms
- Excessive focus on somatic symptoms and catastrophic thoughts related
to these symptoms
- Diagnostic tests that rule out disease or other physical conditions do little
to reassure individuals with SSD or reduce their anxiety
- Symptoms may or may not be associated with another medical condition
- Somatic symptom disorder with predominant pain- persistently high
levels of distress over pain along with an excessive amount of time and
energy devoted to the pain symptoms
Illness Anxiety Disorder
- A chronic pattern (at least 6 months) of preoccupation with having or
contracting a serious illness
- Minimal or no somatic symptoms
- Very anxious and easily alarmed about their health
- Continual checking of ones body or avoidance behaviors
- Individual misinterprets bodily variations or sensations as indications of
a serious illness- extreme distress and alarm
- People with illness anxiety disorder have strong tendency to:
o Catastrophize
o Overgeneralize
o Display all-or-none thinking
, o Show selective attention
- Frequently check for signs of illness, seek reassurance from others,
continuously research and gather information on diseases, and avoid
activities or circumstances they believe might result in an illness
DSM-5 diagnostic criteria for Illness Anxiety Disorder
A. Preoccupation with having, or acquiring a serious illness.
B. Somatic symptoms are not present or, if present, are only mild in intensity. If
another medical condition is present or there is a high risk for developing a
medical condition (e.g., strong family history is present), the preoccupation is
clearly excessive or disproportionate.
C. There is a high level of anxiety about health, and the individual is easily
alarmed about personal health status.
D. The person performs excessive health related behaviors (e.g., repeatedly check
his or her body for illness) or exhibits maladaptive avoidance (e.g., avoids
doctor appointments or hospitals).
E. Illness preoccupation has been present for at least 6 months, but the specific
illness that is feared may change over that period of time.
F. The illness-related preoccupation is not better explained another mental
disorder such as Somatic Symptom Disorder, Panic Disorder, Generalized
Anxiety Disorder, Body Dysmorphic Disorder, Obsessive-Compulsive Disorder,
or Delusional Disorder, somatic type.
Specify whether:
• Care-seeking type: Medical care, including physician visits or undergoing tests
and procedures, is frequently used.
• Care-avoidant type: Medical care is rarely used.
Conversion Disorder (Functional
Neurological Symptom Disorder)
- Motor, sensory, or seizure like symptoms that are inconsistent with any
recognized neurological or medical disorder and result in significant
distress or impairment in life activities
- Muscle weakness, paralysis, unusual movements, swallowing difficulties
and problems with speech
- Psychogenic movement disorders- disturbances of stance or walking,
sensory symptoms- blindness, dizziness, loss of voice
- Diagnosis confirmed when symptoms incompatible with neurological
findings
- Glove anesthesia, inability to talk or whisper combined with the ability to
cough- easily diagnosed symptoms
- Not malingering- feigning illness for an external purpose
