Individuals with somatic symptom disorder report suffering constantly and often for many years from many physical illnesses. However, they do not have any specific, diagnosed medical illnesses that can explain the presence or severity of their symptoms. Still, these symptoms cause distress and negatively impact their ability to function day to day.
The cause of somatic symptom disorder is not known.
There is no medical illness to explain the symptoms, so the disorder is believed to be related to mental and emotional causes. Somatic symptom disorder may also be associated with brain processing.
Somatic symptom disorder is more common in American women, but incidence varies among different cultures.
Other factors that may increase your chance of developing somatic symptom disorder include: Family history of somatic symptom disorderHistory of psychological trauma or early experiences with physical illness, hospitalization, and medical treatment
antisocial personality disorder, substance abuse disorders,
depression, or panic disorderDifficulty copingIndividuals who may be extremely emotional (also known histrionic)
Individuals who are unable to express their emotional distress through language (due to neurological disorders or
intellectual disability), or in cultures that discourage the communication of emotional distress
The physical suffering that people with somatic symptom disorder experience usually begin in the early adult years. It can also begin during the teenage years. Individuals suffer for years, often leading to many unnecessary medical tests and treatments.
People with somatic symptom disorder complain about many physical illnesses that involve many different parts of their body. A diagnosis of somatic symptom disorder requires experiencing an assortment of symptoms that occur over several years.
Somatic symptom disorder may cause: Pain symptoms in any part of the body, such as back, joints chest, or headGastrointestinal symptoms other than pain, such as nausea, vomiting, bloating, or diarrheaSexual symptoms other than pain, such as erectile difficulty, irregular menstrual periods, or excessive menstrual bleeding
Neurological symptoms, such as:
Being off-balanceParalysisWeaknessTrouble swallowingLoss of voiceInability to control the need to urinateDelusions or hallucinationsLoss of touchUnable to feel painAmnesiaTemporary blindness or deafnessSeizures
An emotional event may trigger physical symptoms, sometimes through peripheral nerves (yellow).
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Individuals with somatic symptom disorder may: Complain about these symptoms in a very dramatic way, yet describe the symptoms in very vague or unclear termsVisit more than one doctor for diagnosis and treatment for the same symptomsHave test results that do not confirm any medical illness to explain their symptoms
It is important to understand that a person with somatic symptom disorder is not intentionally producing or pretending to experience these physical complaints.
There are no specific tests to determine whether or not a person has somatic symptom disorder.
Your doctor will ask about your symptoms, medical history, and mental health history. A physical exam will be done. It is important for your doctor to rule out other diagnoses that are sometimes misdiagnosed as somatic symptom disorder.
Diagnosis is made by the following criteria: One or more symptoms that are severe enough to interfere with daily lifeExcessive thoughts, feelings, or behaviors associated with symptoms or concerns about health by one or more of the following: Persistent thoughts about the seriousness of symptomsPersistent anxiety about symptoms and/or overall healthUsing excessive time and energy thinking about symptoms and/or overall health
The goal of treatment is to make you feel like you can control the symptoms and help you begin to function properly in work and social situations. Talk with your doctor about the best treatment plan for you. It is important to have a long-term relationship with your doctor, who should be empathetic and caring about your issues.
Other treatment options your doctor may suggest include: Psychotherapy—Talking with a psychiatrist, psychologist, social worker, or licensed counselor to figure out ways to deals with stressful or painful issues.Cognitive behavioral therapy—A mental health professional will work with you to focus on practical ways to cope with symptoms.
Medications—If you have another disorder, such as depression or anxiety, it may be treated with medications.
There are no current guidelines to prevent somatic symptom disorder.
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LaFrance WC Jr. Somatoform disorders.
Semin Neurol. 2009;29(3):234-246.
Servan-Schreiber D, Kolb NR, Tabas G. Somatizing patients: Part I. Practical diagnosis.
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Somatic symptom disorder. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/somatic-symptom-disorder. Updated November 13, 2013. Accessed June 9, 2016.
Last reviewed June 2016 by Michael Woods MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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