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Mental Health and Somatic Symptom Disorder

People who have excessive and unrealistic worries about their health -- a problem that used to be called hypochondriasis or hypochondria -- has been renamed somatic symptom disorder. Those with the disorder are very worried about getting a disease or are certain they have a disease, even after medical tests show they do not. Further, these people often misinterpret minor health problems or normal body functions as symptoms of a serious disease. An example is a person who is sure that her headaches are caused by a brain tumor. The symptoms associated with somatic symptom disorder are not under the person's voluntary control, and can cause great distress and/or can interfere with a person's normal functioning.

Somatic symptom disorder can occur at any time of life, but most often begins in early adulthood. It appears to affect men and women equally.

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What Are the Features of Somatic Symptom Disorder?

People with somatic symptom disorder -- commonly  called hypochondriacs -- are worried about having a physical illness. The symptoms they describe can range from general complaints, such as pain or tiredness, to concerns about normal body functions, such as breathing or stomach noises. People with somatic symptom disorder are not faking or lying about their symptoms; they truly believe they are sick.

Warning signs that a person might have somatic symptom disorder include:

  • The person has a history of going to many doctors. He or she may even "shop around" for a doctor who will agree that he or she has a serious illness.
  • The person recently experienced a loss or stressful event.
  • The person is overly concerned about a specific organ or body system, such as the heart or the digestive system.
  • The person's symptoms or area of concern might shift or change.
  • A doctor's reassurance does not calm the person's fears; he or she believes the doctor is wrong or made a mistake.
  • The person's concern about illness interferes with his or her work, family, and social life.
  • The person may suffer from anxiety, nervousness, and/or depression.

 

What Causes Somatic Symptom Disorder?

The exact cause of somatic symptom disorder is not known. Factors that might be involved in the development of the disorder include:

  • A history of physical or sexual abuse
  • A history of having a serious illness as a child
  • A poor ability to express emotions
  • A parent or close relative with the disorder; children might learn this behavior if a parent is overly concerned about disease and/or overreacts to even minor illnesses.
  • An inherited susceptibility for the disorder

How Is Somatic Symptom Disorder Diagnosed?

Diagnosing somatic symptom disorder can be very difficult, because people with the disorder are convinced their symptoms are caused by a medical illness.

When symptoms appear, the doctor will begin his or her evaluation with a complete history and physical exam. If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. The psychiatrist or psychologist makes a diagnosis based on his or her assessment of the person's attitude and behavior, and the fact that physical illness has been ruled out as the cause of the symptoms. The psychiatrist or psychologist may administer a personality assessment to confirm the diagnosis of somatic symptom disorder.

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